According to a recent worldwide study, spina bifida and other severe central nervous system disorders impact 5,000 fetuses each year in Europe. 70% of these pregnancies are aborted, and the infants who are born suffer from higher death rates and significant disorders.
By including folic acid into staple foods, as is already done in seventy non-European nations, at least half of the cases can be prevented.
Several thousand occurrences of fetal malformations, such as spina bifida, are brought on by a shortage of folic acid enrichment in Europe. Due to the malformed vertebrae, these congenital illnesses result in an open spinal cord or brain malformation. Though this situation is also associated with various degrees of disabilities, the best-case scenario for the newborn baby is to undergo some correcting surgeries.
In the worst cases, the baby will not survive. Today, following a diagnosis at the beginning of the pregnancy, two out of every three spina bifida-positive fetuses are aborted.
By adding folic acid to diet, which is known to be crucial in the construction of the vertebrae throughout fetal life, it is possible to prevent half of the 5,000 instances per year.
Taking a folic acid supplement is currently advised for all women in Europe who are trying to get pregnant. However, the statistics that indicate the evolution over an 11-year period demonstrate that the voluntary plan is ineffectual and has negative effects on fetuses.
Food enrichment with a minor amount of folic acid has been shown to be safe for the population also without side effects for other age groups and men and an effective way of lowering the level of birth defects. It is the most cost-effective way to reach every woman before pregnancy and to reduce child mortality and the risk of disease. But introducing such a measure would require collaboration between policy makers, stakeholders, researchers and healthcare professionals and a country-specific preparation and monitoring processes.
Associate Professor Rima Obeid
The research results from Aarhus University have just been published in the scientific journal Birth Defects Research.
Spina bifida cut by fifty per cent following folic acid enrichment
70 non-European countries have already introduced folic acid enrichment, including the USA, where it was introduced 17 years ago, as well as Canada and Australia. The measure has reduced fetal defects related to folic acid such as spina bifida by fifty per cent.
“European women have a blood level of folate that is only around half the level recently recommended by the WHO for the prevention of birth defects. There is no doubt that a policy on folic acid enrichment would increase women’s folate and prevent a significant percentage of the spina bifida cases in many European countries and thus prevent deaths and illnesses among children,” says Associate Professor Rima Obeid from Aarhus Institute of Advanced Studies at Aarhus University, who together with an international team of researchers from Germany, Switzerland, and the USA is behind the study.
According to the study, which is based on nine million births that were registered in Europe over an 11-year period, there are 9.17 cases of brain and spinal cord abnormalities for every 10,000 live births. In comparison to southern European nations, the numbers are higher in North European nations like Germany, the Netherlands, and Scandinavia.
Delay in Europe has a price
Because they are worried about negative impacts, European policymakers have been cautious. However, even in the nations that implemented the measure more than 15 years ago, there is no proof of any negative side effects.
“Food enrichment with a minor amount of folic acid has been shown to be safe for the population also without side effects for other age groups and men and an effective way of lowering the level of birth defects. It is the most cost-effective way to reach every woman before pregnancy and to reduce child mortality and the risk of disease. But introducing such a measure would require collaboration between policy makers, stakeholders, researchers and healthcare professionals and a country-specific preparation and monitoring processes,” explains Rima Obeid.
The study also reveals the significant social and financial consequences associated with birth defects of the brain and spinal cord. If folic acid enrichment was implemented, Germany alone, which has the highest number of births each year in Europe, might yearly avoid 441 occurrences of these birth abnormalities. This would also provide estimated savings of EUR 33 million in medical life cycle costs based on a single year (2009).
About spina bifida and other neural tube defects
Neural tube defects e.g. spina bifida are birth defects where there is incomplete closing of the vertebra, so that the spinal cord is exposed.
The diseases develop during the first four weeks of pregnancy.
There are various kinds of brain and spinal cord abnormalities that can cause differing degrees of disability, including muscular paralysis, headaches, incontinence, and movement difficulties.
Hereditary conditions, smoking, maternal obesity and insufficient folate nutrient are among the most common causes of spina bifida.
Neural tube defects can be detected during pregnancy using ultrasound scanning.
