KnowYourself

Self-Assessment

Pregnancy and Childbirth

What is Your Risk for a Neural Tube Affected Pregnancy?

Directions

Circle the response that best describes your (or your female partner’s) characteristics:
 

Yes No  A previous neural tube affected pregnancy. (This increases a woman’s chance of having another neural tube affected pregnancy by approximately 20 times.) 
Yes No Maternal insulin-dependent diabetes. 
Yes No Use of anti-seizure medication. (Valproic Acid/Depakene® and Carbamazapine.) 
Yes No Medically diagnosed obesity.
Yes No Exposure to high temperatures in early pregnancy. (For example, prolonged high fevers and hot-tub use.) 
Yes No Hispanic Race/ethnicity. (Neural tube defects are more common among white women than black women and more common among Hispanic women than non-Hispanic women.) 
Yes No Lower socio-economic status. 
Yes No Daily diet low in folic acid. (Folate is a B-vitamin found in green leafy vegetables, orange juice from concentrate, fortified cereals, liver and other foods.).

Scoring


For each characteristic numbered that you circled  “Yes” in this self-assessment then you (or your female partner) have a known risk factor for having a pregnancy affected by an neural tube defect (NTD).
 

Information


There are approximately 60 million women of childbearing age in the United States. Any woman who is capable of becoming pregnant could have an NTD-affected pregnancy. It is not possible to predict which women will have a pregnancy affected by an NTD. Ninety-five percent of women with NTD-affected pregnancies have no personal or family history of NTDs. However, some risk factors are known.

More studies of the prevention of NTDs among other higher risk women need to be done. Nevertheless, these women should follow the PHS recommendation of 400 micrograms (0.4 milligram) of folic acid daily throughout their childbearing years. If you are planning a pregnancy, it is advisable for you to discuss your potential risk for having an affected child with your physician. You should talk about the advantages and disadvantages of using 4,000 micrograms (4 milligrams) periconceptionally (that is, one month before conceiving a baby through the first three months of pregnancy).

The CDC guideline published in August 1991 and the Public Health Service guideline published in September 1992 recommend that women who have had a previous NTD-affected pregnancy consume 400 micrograms (0.4 milligram) of folic acid daily if they are not planning a pregnancy and 4,000 micrograms (4.0 milligrams) of folic acid daily under the direction of their health care provider if they are planning a pregnancy.  By consuming 400 micrograms of folic acid everyday, you can reduce your risk of your unborn children developing spina bifida by 50%-70%.

Folic acid is a B-vitamin. The recommended amount to prevent spina bifida and other neural tube defects is 400 micrograms (0.4 milligrams) of synthetic folic acid daily. This can be consumed in three ways:

  1. Most multivitamins contain 400 micrograms (0.4 mg) of folic acid. Vitamin supplements containing folic acid can be bought at grocery, pharmacy, or discount stores that sell vitamins.
  2. Breakfast cereals fortified at 100% of the daily value of folic acid per serving. Total, Product 19, Cheerios Plus and Smart Start are some of these types of cereal products.
  3. Foods fortified with folic acid (all enriched cereal grain products such as enriched pasta, rice, bread and cereal) in addition to a healthy diet. Foods rich in folate are green leafy vegetables, orange juice from concentrate, fortified cereals, liver and other foods.

Source

This self-assessment instrument was developed from information provided by the Centers for Disease Control and Prevention in Preventing Neural Tube Birth Defects: A Prevention Model and Resource Guide, Who Is at Risk for Having a Baby With an NTD? available at: http://www.cdc.gov/nceh/prevent/flo/ntd/preface/aboutntd.htm

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Copyright 1999.
Judith A. Baker
All Rights Reserved.