Each year in France, 800 pregnancies are affected by poor closure of the neural tube in developing fetuses *. This risk could be much reduced if all women of childbearing age and expressing a desire to have a child benefited from folate supplementation (or folic acid), also called vitamin B9.
Three in four women lack vitamin B9
Folic acid is naturally present in some foods such as fish livers, nutritional yeast, egg yolk and dark green leafy vegetables (cabbage, spinach, lamb’s lettuce, broccoli …). But the recommended daily allowance is 400 micrograms, which is 15 broccoli or two lettuces a day! The appropriate dose reaches even five milligrams for obese women (BMI > 30) or with a history of neural tube closure abnormalities.
Almost three-quarters of women of childbearing age have dietary folate intakes below 100% of recommended nutrient intakes and 7% of women of childbearing age have severe folate deficiency. Yet according to network data Eurocat (European Surveillance of Congenital Anomalies), 90% of pregnant women or women who want to have children are not properly supplemented with folic acid.
Neural tube closure abnormality: one in 1,000 births
Insufficient supply of vitamin B9 in the mother may play a role in abnormalities of the nervous system in the fetus related to a defect in the formation of the central nervous system: this is what doctors call the tube closure abnormality. neural. The defect will occur in the spine, between the base of the skull and the lower end (the sacrum). Most frequently, this type of anomaly is the cause of pathologies such as spina bifida, a congenital disease responsible for loss of sensitivity in the limbs and paralysis, but also encephalocele (brain that develops in outside the skull) and anencephaly (partial absence of brain). a prenatal ultrasound diagnosis makes it possible to detect such anomalies.
However, “even if four out of five women choose in this case a medical termination of pregnancy, some refuse and the children who are born are severely disabled“specifies François Haffner, president of theNational Association Spina Bifida and Handicaps Associés. “These children will need multiple surgeries and hospitalizations throughout their lives. The cost of a person declaring such diseases is extremely high both financially and humanly: these patients will suffer from orthopedic problems, cognitive disabilities, sphincter disorders leading to a urinary incontinence and fecal very disabling for social development, sexual disorders but also symptoms of depression and poor living. The consequences on family and professional life are very serious“reveals François Haffner. In France, one child per 1,000 births suffers from spina bifida. But supplementation of the mother with vitamin B9 makes it possible to drop this proportion to 0.3 babies per 1,000 births.
At least a month before you get pregnant
The route of vitamin B9 is therefore particularly interesting for reducing the incidence of these nervous pathologies: “the risks of neural tube closure abnormalities are due to several factors: environmental pollutants, genetic factors, and folate deficiency. It is on this last point that we can act the most“insists Doctor Thierry Harvey, obstetrician gynecologist at the Diaconesses Croix Saint-Simon hospital center, in Paris.
But since the development of the nervous system is very early in the fetus (between the 21st and 28th day of pregnancy), folate supplementation should begin at least one month before design, which is not always obvious: “the problem is that it must be administered to women who wish to become mothers at the right time, that is to say already at least a month before becoming pregnant. However, one in two women did not plan their pregnancy“underlines François Haffner. So to act in time, Doctor Harvey gives the following advice:”Any consultation for contraception should be a preconception consultation, that is, any woman who has contraception that she can stop herself (pill, patch, ring) should have full information on the emergency contraception as well as on folic acid supplementation when stopping contraception in case of desire to become pregnant. According to Dr. Harvey, before pregnancy, as soon as the desire to get pregnant point the tip of his nose, “women should benefit from a consultation that makes it possible to health check-up of the mother-to-be (weight, smoking, vaccination …) for preventive purposes “to minimize the risk to the baby.
So if you’re starting to think baby, think about vitamin B9 too!
* Source : press conference EFFIK on the occasion of the release of the new food supplement Gynéfam®, October 13, 2015
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