Neural tube defects: risk factors and prevention

Neural tube defects are abnormalities that can occur in the brain (anencephaly, encephalocele), spine (spina bifida, myelomeningocele, myelodysplasia), both brain and spine (craniorachischisis) or spinal column of a developing embryo that are present at birth. They arise when the neural tube, the embryonic precursor of the brain and spinal cord, fails to close during neurulation. Many cases of neural tube defects occur worldwide each year in more than 300,000 newborn babies and are a significant cause of infant death and lifelong disability. Most neural tube defects are preventable. The prevalence of these abnormalities has decreased in the past 20 to 30 years due to periconceptional folate supplementation, food fortification and decreased exposure to environmental factors. Women who are planning to conceive should be informed about the importance of folic acid in fetal development and encouraged to take 400 μg/day of folic acid supplements. Numerous research studies have shown that taking this dosage of folic acid before and during early pregnancy significantly reduces the risk of neural tube defects. For that reason it is important to increase the awareness of women in childbearing age about the necessity of primary prevention and folate intake which is a strong factor that has wide implications in public health in reducing the mortality and morbidity of offspring.