Europe needs to put folic acid in food products: scientists
Folic acid deficiency in European women costs billions and leads to thousands of birth defects.
Five thousand children are born with spina bifida and other serious defects of the central nervous system each year in Europe. The occurrence of the defects have been linked to lack of folic acid, also known as vitamin B9, in women during pregnancy.
In Germany alone, the life-long medical costs associated with 241 annual cases of spina bifida and damage to the central nervous system amount to 63 million euros for those affected.
So concludes a new study, which for the first time quantifies the economic and human costs of folic acid deficiency in women.
The researcher behind the study, Associate Professor Rima Obeid from Aarhus Institute of Advanced Studies at Aarhus University, Denmark, believes it is time that Europe tackles the problem and enriches grocery items such as flour with folic acid, like they do in the US, Australia, and Canada.
Doing so has reduced both the number of children born with spina bifida and the financial burden brought about by medical costs by up to 50 per cent in those countries.
"[Many] European women don’t have adequate levels of folate in the blood. A policy of food enrichment could increase women's intake of folic acid and prevent a substantial proportion of the cases of spina bifida in many European countries,” says Obeid.
“This would both prevent deaths and disease among children and could give a great saving on medical costs," she says.
Obeid's study was recently published in the scientific journal Birth Defects Research.
Folic acid should help the spinal cord fuse
Lack of folic acid in the blood in the early stages of pregnancy can have serious consequences for the foetus. This is why the Board of Health in Denmark recommends that women take folic acid supplements 4 weeks before they intent to become pregnant, and up to 12 weeks into the pregnancy.
If women do not have adequate levels of folic acid in the blood, the foetal spinal cord does not fuse properly. This can have serious consequences as the foetus can die or be born with serious disabilities.
Damages to the spinal cord are typically discovered during early scans of the foetus.
About 70 per cent of all parents decide to get an abortion when they realise that their future child will require expensive surgical treatment that most often result in physical handicap.
Doctors: Folic acid enrichment of groceries is a good idea
Two medical doctors, Katherine Friberg from Herlev Hospital and Finn Stener Jørgensen from the Ultrasound Clinic at Hvidovre Hospital, have also been studying the problem of folate deficiency.
They recently released a status report in the Journal of Medical Doctors and an article in the Danish Medical Journal, where they detail the status of the problem of folic acid intake among pregnant women.
Friberg and Jørgensen looked at the folic acid intake in almost 500 women who showed up for a nuchal scan--a non-invasive ultrasound scan in the first trimester of pregnancy to identify risk of Down syndrome and other chromosomal defects.
Both doctors agree with Obeid: folic acid enrichment of selected foods is a good idea to minimise the occurrence of spina bifida and other damage to the central nervous system.
Examined nine million children
Obeid examined birth records from all European countries. She identified the amount of children born with spina bifida or other defects, and compared it with the total number of births.
She found that in Denmark, 11 children out of 10,000 are born with spina bifida.
In Ireland and Poland the figures are higher, as Poland does not have a tradition of scanning of foetuses and abortions are illegal in Ireland.
Furthermore, proportionally more children are born with spina bifida in northern Europe than in the south.
According to Obeid, this is partly explained by diet.
"We can get folic acid through our diet. Raw, leafy vegetables are especially rich in folic acid. So this may explain why those in southern Europe have more folic acid in their blood than in northern Europe," she says.
Obeid suggests that folic acid supplements be made freely available, making it easier for women to take them both before and during pregnancy.
"The United States began enriching foods with folic acid 17 years ago. The fear of doing so in Europe is over harmful side effects, but there has been no evidence of such side effects in the US where the system has been in place for years," says Obeid.
Translated by: Cetherine Jex
- "Preventable Spina Bifida and Anencephaly in Europe", Birth Defects Research (2015), DOI: 10.1002/bdra.23400
- "Few Danish pregnant women follow guidelines on periconceptional use of folic acid", Danish Medical Journal (2015)