Healthy Before Pregnancy

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Healthy Before Pregnancy

• March of Dimes
• NC Preconception Health Campaign

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Multivitamins Take them for life Lesson Plan 2
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Birth defects The big picture

• 1 in 33 U.S. babies is born with birth defects
  (120,000)
• Most common include
• Heart defects
• Cleft lip/palate
• Down syndrome
• Spina bifida (neural tube defect)

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Birth defects that can be prevented

• Neural tube defects (NTDs)
• Spina bifida
• Anencephaly

Source National Center on Birth Defects and
Developmental Disabilities, Centers for Disease
Control and Prevention
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How do NTDs occur?

• The brain and spine start as a tiny pancake of
  tissue
• It folds inward and makes a tube
• Around 28 days after conception the tube zips
  up
• If the tube does not close completely a hole is
  left and an NTD is formed

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Neural tube defects

• Approximately 200 pregnancies are affected by an
  NTD each year in North Carolina
• 2,500-3,000 U.S. babies are born each year with
  an NTD
• Another 1,500 are still born, spontaneously
  miscarried or terminated

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Main message

• If all women consumed the recommended amount of
  folic acid before and during early pregnancy, up
  to 70 percent of all NTDs could be prevented
• The U.S. Public Health Service recommends that
  ALL women of child- bearing years take 400
  micrograms (mcg) of folic acid every day

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Spina bifida

• Spina bifida occurs when the lower end of the
  developing neural tube fails to close (just 23-28
  days after conception).
• What is the size of the embryo at this time?

Source http//www.visembryo.com/baby/stage1.html
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Answer
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Spina bifida
Photo source National Center on Birth Defects
and Developmental Disabilities, Centers for
Disease Control and Prevention
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Spina bifida diagnosis

• Disabilities may include
• Paralyzed legs
• Loss of bowel control
• Loss of bladder control
• Learning disabilities

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Quality of life

• 80-90 percent of infants who are born with spina
  bifida will live.
• Thanks to advancements in treatment and
  prevention, those born with this challenging
  birth defect are living longer, more productive
  lives than was dreamed of just 20 years ago. 

Source National Center on Birth Defects and
Developmental Disabilities, Centers for Disease
Control and Prevention
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Anencephaly

• Anencephaly is a fatal condition in which the
  upper end of the neural tube fails to close.
• The brain either never completely develops or is
  totally absent.

Source National Center on Birth Defects and
Developmental Disabilities, Centers for Disease
Control and Prevention
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Anencephaly

• Prognosis
• Miscarriage (spontaneous loss)
• Stillbirth
• Neonatal death

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Whos at risk?

• All women capable of becoming pregnant are at
  risk of having a baby with an NTD BUT
• Latina women are at a much higher risk

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Prevalence of neural tube defects by type
North Carolina, 1998-2008 (excl. TABs lt 20 weeks)
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Other birth defects

• Folic acid may also protect against
• Development of infant heart defects
• Cleft lip with/without cleft palate

Photo source National Center on Birth Defects
and Developmental Disabilities, Centers for
Disease Control and Prevention
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Prevention Its all about timing

• The U.S. Public Health Service recommends that
  all females who have started menstruation take a
  daily multivitamin with 400 mcg of folic acid
• If all women consumed the 400 mcg of folic acid
  before and during early pregnancy, up to 70
  percent of all NTDs could be prevented

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Take a multivitamin every day

• Two-thirds of U.S. women do not consume enough
  folic acid and/or folate!

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How can you get enough folic acid?

• Food (folate)
• Leafy green vegetables, orange juice, beans
• Fortified food (folic acid)
• Cereals, breads, nutrition bars
• Multivitamins!

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Folate

• Folate is an essential nutrient that humans
  cannot easily synthesize and is found naturally
  in foods.
• Absorption depends on the food itself, how it is
  cooked, and individuals ability to metabolize
  folate.

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Fit folic acid into your life!

• Taking a pill is better than eating a vitamin in
  its natural food form
• Folic acid is most absorbable in a multivitamin
  or supplement (compared to folate found in foods)

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The FDA takes action 1996

• Ordered enrichment of all flour or grain
  products, 140 mcg per 100g of grain product
• Approved the use of health claims on products
  that contain significant amounts of folic acid
• However, these efforts have proven to be
  insufficient for full prevention of birth defects

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Some cereals that contain 100 of the daily value
of folic acid

• General Mills Harmony
• Total
• Product 19
• Quaker Oats Cinnamon Crunch
• Cheerios Plus
• Smart Start

For informational purposes only. The March of
Dimes does not endorse or recommend any brand,
manufacturer or type of cereal product.
For a complete list go to www.cdc.gov/ncbddd/folic
acid/cereals.html
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MultivitaminsSo whats in it for me?

• Fills in the nutrition gaps
• Some studies suggest that folic acid has other
  benefits
• May protect against heart disease, stroke and
  certain cancers
• May protect against other birth and heart defects

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Multivitamins!
For illustrative purposes only. The March of
Dimes does not endorse or recommend any brand,
manufacturer or type of multivitamin or
supplement.
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Tips on taking multivitamins

• Combine taking a multivitamin with another
  everyday activity, such as brushing your teeth.
• Place your bottle of multivitamins where youre
  likely to see it.
• Try chewable multivitamins if you have trouble
  swallowing regular multivitamins.
• Try taking a multivitamin with food or at night
  if it upsets your stomach.
• Buy generic multivitamins They can be as
  effective as name brands and often cost less.
• Check the expiration date on the bottle.

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Other important research may benefit adults

• Studies show that folic acid may reduce
• Cardiovascular disease
• Alzheimer's
• Cervical cancer
• Colon cancer
• Stroke