Risk, Prevention, & Treatment

Q: What are the factors that can increase my chances of having a pregnancy affected by Spina Bifida?

A: Spina Bifida can happen in any pregnancy, and 95% of the occurrences have no family history. The exact cause of Spina Bifida is unknown but likely involves a combination of genetics and environment. Factors that increase risk of a Spina Bifida-affected pregnancy include:

  • Previous pregnancy affected by Spina Bifida
  • First, second, or third degree relative living with Spina Bifida
  • Taking valproic acid or carbamazepine (anti-seizure medications)
  • Having diabetes before the beginning of pregnancy (not gestational diabetes)
  • Inadequate folic acid intake
  • Pre-pregnancy obesity
  • Low vitamin B-12 levels in the body
  • Having high temperatures early in pregnancy (which may include fever, or exposure to the heat of hot tubs, saunas, and tanning beds)

Q: Am I at greater risk for a heart attack as a wheelchair user who doesn't do regular aerobic activity?

A: There is no information specifically looking at individuals living with Spina Bifida, but our knowledge of the general adult population probably applies. Risk factors for heart attacks include the following:

  • Smoking (the most important risk factor)
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Obesity
  • Family history of heart disease and early heart attacks
  • Males over 50 years of age and post-menopausal females

It is important to see your primary care provider regularly to address these risk factors. For more information, review SBA’s health information sheets on diabetes, hypertension, and obesity.

Regular physical activity has been shown to protect against coronary heart disease. The National Center on Physical Activity and Disabilities (NCPAD) offers excellent ideas for adaptive exercise and tips for improved cardiovascular health. Also, the Health Guide for Adults Living with Spina Bifida includes a section on physical activity and weight control that is helpful for adults concerned about their general health.  This publication is available at SBA's Marketplace.

Q: Please explain what umbilical cord blood could do for people with Spina Bifida. What hospitals do this?

A: Umbilical cord blood is one type of method for retrieving stem cells. Stem cell transplants are an important part of current and future treatment of some diseases which affect the blood and immune system, such as leukemia and some types of anemia. There is currently no indication of its use in the treatment of Spina Bifida. This is because (currently) stem cells can only be transformed into blood cells, not other tissues. However, the future holds many exciting possibilities that stem cells may be used to treat neurological disorders like Parkinson's Disease and spinal cord injuries. There is hope for Spina Bifida also as the technology becomes more advanced and widespread. The March of Dimes Web site has a very informative link on the topic of umbilical cord blood and its relevance to stem cell transplants which may be of interest.
Furthermore, the National Marrow Donation Program has provided a list of hospitals that participate in the cord blood banking program.

Q: I read that drinking tea can affect absorption of folic acid in some women. Is this true?

A: Some preliminary research suggests that consumption of some black and green tea inhibits absorption of folic acid and naturally occurring folate.

Q: My sister has a baby with Spina Bifida. Should I increase my folic acid intake from the regular dose of 400 mcg to the higher dose of 4 mg to reduce my risk?

A: Although there is less science behind recommending 4 mg of folic acid for relatives of women who have had a Spina Bifida-affected pregnancy, the risk to women taking this dose is minimal while the potential benefit is considerable. Therefore, six to eight months of high folic acid intake is worth consideration for women in this unique situation. For more information on the role of folic acid in the prevention of Spina Bifida, review SBA’s health information sheet on folic acid.