I have a question about Spina Bifida that may not have a well-researched answer. I’ve read that the mother of a child with Spina Bifida has an increased risk of having another child with Spina Bifida, but is there any paternal link? If the father of a child with Spina Bifida remarries and his new wife becomes pregnant, is there any increased risk of Spina Bifida for her child?

You are correct that there is no established research on the risk of having additional children with Spina Bifida in fathers who have a child with Spina Bifida. There is strong research showing a significant decrease in the risk of Spina Bifida in subsequent pregnancies for mothers of children with Spina Bifida who take 4mg of folic acid before and during pregnancy. Note this is 10 times the dose for the general population who are recommended to take 0.4mg (400micrograms) of folic acid daily.

Because of this benefit, many Spina Bifida providers would recommend the same higher dose of 4mg folic acid for the father’s new wife, which should be started before she becomes pregnant. This should not come from prenatal vitamins because that would result in too much of the other vitamins. Folic acid comes as its own supplement and there is no evidence of significant toxicity at this dose of folic acid for the mother or the baby. Therefore, the risk/benefit profile favors recommending the higher dose for these women.

There is more on folic acid supplementation in the November 2007 Ask the Doctor archives and on risk factors for Spina Bifida in the June 2007 Ask the Doctor archives. There is also a Fact Sheet on folic acid. Both Ask the Doctor Archives and Fact Sheets are found on the National Resource Center page which can be found under the Programs/Services drop down menu on the Spina Bifida Association Home Page. There is more on recurrence prevention and folic acid benefits on the Prevention page which is also under the Programs/Services drop down menu.