SPINA BIFIDA AND FOLIC ACID

News: Spina Bifida, a largely preventable birth defect, continues to affect over 25,000 children every year in India, mainly due to lack of awareness and absence of a national folic acid–based prevention strategy

Spina Bifida

• Spina Bifida is a birth defect of the spinal cord.
• It occurs when the spine and spinal cord of the fetus do not fully develop during the early weeks of pregnancy (embryonic period).

Why it is Serious

• Causes permanent disability, often from birth
• Leads to: Paralysis of legs, Bowel and bladder incontinence, Orthopaedic deformities, Hydrocephalus (water in the brain)
• Requires lifelong medical care and rehabilitation

Causes of Spina Bifida

• Exact cause is not fully known
• Results from a combination of factors:
  • Nutritional deficiency (especially folate)
  • Genetic predisposition
  • Environmental factors
• The defect develops before many women even know they are pregnant
• Hence, pre-conception nutrition is crucial.

Prevention: The Role of Folic Acid

• Folic Acid: B-vitamin (Vitamin B9), Essential for neural tube development
• Scientific Evidence–Since 1991, studies have proven that: Pre-conception folic acid intake can prevent 70%+ cases
• Treatment: No complete cure
• Recommended:

o Before conception

o During early pregnancy

Global Best Practices

• Many countries have: Mandatory food fortification (flour, salt, grains)
• National awareness campaigns
• Result: Spina Bifida prevalence reduced to below 1 per 1,000 births

India’s Situation

• One of the highest prevalence rates globally
• No Mandatory folic acid fortification, no Large-scale awareness campaign
• Healthcare access gaps: Over 75% of affected children lack proper medical care

Way Forward

• National awareness campaign on Spina Bifida
• Pre-conception counselling for women
• Food fortification with: Folic acid, Vitamin B12
• Strengthen maternal healthcare at primary level
• Improve rehabilitation support systems