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A simple vitamin deficiency that can be dangerous.

The possibility of having a child with a serious birth defect haunts every expectant mother. Among the most devastating congenital defects are anencephaly and spina bifida. These are also known as neural tube defects because the embryonic nervous system cells (the neural tube) fail to develop into a fully formed brain and spinal cord.

Anencephaly (literally, "without a brain") is the most deadly defect, often producing so-called anencephalic "monsters"--full-term babies lacking a brain and the upper portion of the skull. The infant usually succumbs as soon as the umbilical cord is severed, thus sparing the mother the agony of attempting to care for it.

Spina bifida ("cleft spine"), on the other hand, is likely to affect the child and its family for life. Failure of the bony spinal column and overlying skin to close completely leaves the delicate nerve fibers of the spinal cord exposed, with resultant paralysis or other complications of nerve damage.

An unknown number of pregnancies ends in miscarriage because of neural tube defects, and some 2,500 American children are born with such defects each year. The cost of caring for those who survive is enormous, in terms of both dollars and the emotional stress on the family. Recent studies indicate, however, that many neural tube defects can be prevented by adequate dietary intake of the vitamin folio acid.

Folio acid, in the form of folates derived from it, is found in many foods, but cooking can destroy as much as 90 percent of it.

All tissues require folate for normal growth, but the most notable sign of folate deficiency is the same form of anemia that occurs with vitamin [B.sub.12] deficiency. Folate deficiency is a common complication of alcoholism and diseases of the small intestine, in which absorption of the vitamin is impaired.

An adequate intake of folio acid is especially important throughout pregnancy. Because the neural tube develops very early in preg- nancy, it is important for women of child-bearing age to have an ad- equate folate intake before they become pregnant and to maintain that level as long as they are able to become pregnant. Waiting antil pregnancy has occurred may be too late to avoid the possibility of neural tube defect in the fetus.

The national Centers for Disease Control and Prevention recommend that all women of child-bearing age receive 400 micro-grams (0.4 milligrams) of folate daily. Given the variation in most diets and the effect of cooking on folate, a dietary supplement is the best assurance of a continuously adequate intake.

For mothers of a child with a neural tube defect, the recommended dose of 0.4 mg is increased tenfold to 4 mg daily (4,000 micrograms) beginning one month before attempting to become pregnant.
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Title Annotation:folic acid deficiency
Publication:Medical Update
Date:Mar 1, 1993
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