Folic acid could prevent 40 spina bifida cases yearly

Up to 40 cases of children born with spina bifida could be prevented each year by ensuring women take folic acid before pregnancy, an Oireachtas committee has been told.

With the cost of operations and other treatment for children with spina bifida averaging €500,000 in a lifetime, this could result in savings of €20 million for the health service, according to Prof Michael Turner, professor of obstetrics at UCD. "We could do a lot with that money," he told the Oireachtas health committee. Prof Turner said pregnancy complications linked to neural tube defects such as spina bifida was a public health issue of major importance. Two-thirds of such congenital defects could be prevented through adequate intake of folic acid before and during early pregnancy.

Research shows the rate of neural tube defects in Ireland is increasing at the same time as the folic acid intake of pregnant women is declining. Plans to introduce mandatory fortification of food with folic acid were shelved some years back and the EU has been slow to introduce common standards.

National guidance

Prof Turner called for the national guidance to women of childbearing age to be updated so that all women who could potentially become pregnant within the next year were taking folic acid supplements daily. High-risk cases, such as women with diabetes or who are obese, should be taking higher doses.

He also called for a renewed public health campaign to increase awareness about the issue. Safefood is due to start such a campaign on social media next month. The issue of mandatory food fortification needed to be reviewed urgently by the Government, he added.

While a pan-European approach was needed, up to now European governments had been “sitting on their hands” on the issue. This may be because it was not as important clinically in other countries, where the rate of neural tube defects was far lower than in Ireland, he suggested.

Prof Turner said there were huge advantages to the provision of an early diagnosis of spina bifida in pregnancy. However, ultrasound services in many smaller maternity units were “deficient” compared to large hospitals.