October brings awareness to the birth defect spina bifida - Albuquerque Journal

October brings awareness to the birth defect spina bifida

October is National Spina Bifida Awareness Month.

Spina bifida is the most common birth defect of the nervous system. It affects about 1,600 babies per year and an estimated 166,000 people are living with spina bifida in the U.S. right now.

Spina bifida means “split spine” and it occurs in the first 28 days of fetal development. It is a type of neural tube defect where the spinal column does not close as it should. A developing embryo has a flat plate of neural cells whose sides must fold up to create a tube that will eventually form the spinal column and brain.

If there are places along the spinal column that do not fuse together as they should, it can allow parts of the spinal cord to push out through the opening, causing damage, and impacting many different body systems and functions.

There are three main types of spina bifida: occulta, meningocele and myelomeningocele.

Spina bifida occulta is the mildest form and is most often hidden; about 15% of healthy people have this condition and don’t know it. The individual is unaware, having no symptoms, and the defect in the spinal column is usually picked up as an incidental finding on a back X-ray.

A meningocele occurs when the spinal cord surrounded by its protective sac and fluid is pushed out through the defect in the spinal column. The sac is often covered by skin and the spinal cord is usually relatively protected so that individual may have only minor disabilities from this type of spina bifida.

The most severe form is a myelomeningocele, which occurs when the spinal cord and nerves come through the opening in the spinal column and are damaged.

This is most often repaired within a few days of birth to protect the structures and prevent infection.

If found during a prenatal ultrasound, it is sometimes possible to repair this defect while the baby is still in the womb. It is often associated with having too much fluid on the brain, called hydrocephalus.

Spina bifida is sometimes also called the “snowflake condition,” meaning no two patients have the same set of disabilities and severity of health issues. Paralysis or muscle weakness is common and may impact the individual’s ability to walk or move. They can also have joint problems in their feet, knees and hips.

Hydrocephalus is a very serious associated problem that requires surgery and can be fatal.

The muscles that control one’s ability to urinate and defecate can also be impacted. This can contribute to urinary tract infections, kidney damage and constipation.

It is not clearly understood why, but people who have spina bifida also have higher rates of latex allergy. It could be due to more frequent exposure to latex during evaluations and procedures or something else entirely.

It is important to try and limit latex exposure at an early age by being careful about use of such latex-containing products as bottle nipples, pacifiers, teething toys, mattress covers, etc.

About 10-15% of people with spina bifida have a seizure disorder. Vision problems and learning disabilities are also common.

Additionally, there can be psychological difficulties due to having to cope with various challenges. Helpful supports depend on what issues the individual has and what their needs are.

The cause of spina bifida is not completely understood. There are genetic and environmental factors, associated maternal health conditions and prenatal exposure to certain medications that have been linked to the development of spina bifida.

Maternal diabetes mellitus, exposure to high temperatures in early pregnancy from hot tub use or prolonged fever, exposure to certain antiseizure or mood-stabilizing medication (valproic acid, carbamazepine), maternal folic acid (folate) deficiency, and a personal history or previous history of having a child with a neural tube defect, all increase one’s risk of having a child with spina bifida.

The best prevention is making sure women of child-bearing age are getting enough folic acid before becoming pregnant and for the first three months of pregnancy. A supplement containing 400 mcg, or 0.4 mg, is adequate.

If there is a previous history of a baby born with spina bifida, or if the mother has spina bifida, the recommended dose of folic acid is 4,000 mcg or 4 mg. Of course, good prenatal care is also paramount for a healthy pregnancy and healthy baby.

People living with spina bifida can lead fulfilling lives, be successful in their academic and professional pursuits, and have families of their own.

For further information, please visit: spinabifidaassociation.org, medicalhomeportal.org, and cdc.gov.

Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to melissaemason@gmail.com.

 

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