Spina bifida

There several conditions that can affect a newborn baby.  East Tennessee has an unusually high frequency of births with the severe form of spina bifida.  Spina bifida is a type of neural tube defect (NTD) that affects the spine, is usually apparent at birth, and can happen anywhere along the spine if the neural tube does not completely close. The backbone that protects the spinal cord does not form and close as it should, resulting in damage to the spinal cord and nerves, often causing physical and intellectual disabilities that range from mild to severe.  Severity depends on the size and location of the opening in the spine, and whether part of the spinal cord and nerves are affected.

Three of the most common types of spina bifida are myelomeningocele, meningocele, and occulta.  When people talk about spina bifida, they are usually referring to myelomeningocele spina bifida, the most severe form of spina bifida.  A sac of fluid, with part of the spinal cord and nerves, comes through an opening in the baby’s back, and are damaged, causing moderate to severe disabilities involving the lower body. With meningocele spina bifida a sac of fluid comes through an opening in the baby’s back,  but without the spinal cord.  Usually little or no nerve damage is present, causing only minor disabilities. Occulta spina bifida is the mildest type of spina bifida and often called “hidden” spina bifida.  There is a small gap in the spine, but no opening or sac on the back. The spinal cord and the nerves usually are normal,and many times it is not discovered until late childhood or adulthood. This type of spina bifida usually does not cause any disabilities.

During pregnancy there are screening tests (prenatal tests) to check for spina bifida and other birth defects.  The “triple screen” looks for neural tube defects and other issues.  In an ultrasound the doctor can frequently see if the baby has spina bifida, and amniocentesis, a test of the amniotic fluid surrounding the baby in the womb, can reveal the presence of  spina bifida.  After the baby is born,  there is sometimes a hairy patch of skin or dimple on the baby’s back, resulting in an image scan to get a clearer view of the spine and bones to determine if spina bifida exists.

All causes of spina bifida are not know. The role of genes and the environment are being studied. There are ways, before and during pregnancy, to reduce the risk of spina bifida. The CDC publishes these precautions:

Take 400 micrograms (mcg) of folic acid every day. If you already have had a pregnancy affected by spina bifida, talk with your doctor about a prescription to take 4,000 mcg (4.0 milligrams). Folic acid prevents most, but not all, cases of spina bifida. Spina bifida happens in the first few weeks of pregnancy, often before a woman knows she’s pregnant, thus it is important that all women who can become pregnant take folic acid. (In 1992, the U.S. Public Health Service recommended that all women of childbearing age consume 400 micrograms (mcg) of folic acid daily to reduce the risk of having a pregnancy affected by neural tube defects  and mandated adding folic acid to all enriched cereal grain products.)

Talk to your doctor or pharmacist about any prescription and over-the-counter drugs, vitamins, and dietary or herbal supplements you are taking. Learn about medication and pregnancy.

If you have a medical condition―such as diabetes or obesity―be sure it is under control before you become pregnant.

Avoid overheating your body, as might happen if you use a hot tub or sauna.

Treat any fever you have right away with Tylenol® (or store brand).