Sexually Active Teens Miss Chance to Prevent Spina Bifida

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March 23, 2000 (Arlington, Va.) -- Young women aren't getting a powerful prevention message that could spare their babies from neural tube defects such as spina bifida that are linked to a vitamin deficiency. A study done on sexually active women, primarily blacks and Hispanics in Houston, shows that relatively few are consuming enough folic acid either through diet or folic acid supplements.

"We're not doing enough. The messages really aren't out there," says lead investigator Mariam Chacko, MD, of the department of pediatrics at the Baylor College of Medicine in Houston. She presented her findings at an adolescent medicine conference here this week.

Deficiency of a B vitamin called folic acid prior to getting pregnant has been linked to birth defects known as neural tube defects (NTDs). The most common and well-known NTD is spina bifida. These disorders occur when the tube that covers the spinal column fails to develop properly. This defect can result in spina bifida, miscarriage, and even a condition where very little brain and spinal cord develops. About half of NTDs are linked to folic acid deficiency, something entirely preventable with proper diet or supplements.

The study was based on the results of a questionnaire given to about 200 women between the ages of 13 and 22 seeking services at reproductive health clinics. The majority of the women had at least heard of folic acid. However, Chacko found that only 12% of the patients were taking a daily multivitamin containing the recommended folic acid dose of 400 micrograms. At the same time, 86% of the women ate no foods that could be described as folate rich, such as fortified cereals, spinach, liver, or orange juice, during a week's study period. About one-third said they did consume at least one folate-rich food per week.

Chacko tells WebMD she was surprised at the high number of teens not eating folate-rich foods.

It's important for teens or any woman who might have a child to get enough folic acid, either through foods or vitamins, because by the time a pregnancy is discovered, it's too late to prevent a neural tube defect, says Chacko.


"[Teen] awareness programs are needed to increase knowledge and prevention of spina bifida and neural tube defects," says Chacko. Since teens often act spontaneously and many of these pregnancies are unplanned, Chacko says a multivitamin containing folic acid is the most reliable way to guarantee that the mother will have enough folates in her body to prevent problems. Some 4,000 babies in the U.S. are born each year with spina bifida, and while treatment has improved, they will all probably suffer a lifetime with severe physical and learning disabilities.

Chacko says she's doing a three-month follow-up on the women to see if they're still taking the vitamins provided as part of the study. Not all of the problem is motivation, however. In many cases, paying for vitamins or proper foods is an issue.

Vital Information:

  • If they do not get at least 400 micrograms of folic acid each day before and during their pregnancy, women face higher risks of having a baby with neural tube defects such as spina bifida. Experts recommend that women who are sexually active during their childbearing years take enough folic acid every day, in case they become pregnant.
  • In a recent report, researchers say not enough young women are getting this message. After surveying about 200 teen-age clients of reproductive clinics in Houston, they found only 12% of the respondents took a daily multivitamin with the recommended amount of folic acid. And few regularly ate folate-rich foods such as spinach and fortified cereals.
  • The ability to buy these types of foods and supplements may contribute to how many women consume enough folic acid.
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