Spina Bifida (“Open Back”): Prevention

To prevent spina bifida, attention must be paid to reducing individual risk factors.

Behavioral risk factors

• Diet
  • Folic acid deficiency
  • See below “Prevention with micronutrients”.

Disease-related risk factors

• Diabetes mellitus poorly controlled in the early stages of pregnancy.

Medication

• Teratogenic drugs:
  • Antiepileptic drugs – e.g., valproic acid and carbamazepine.

Prevention factors (protective factors)

• Genetic factors:
  • Genetic risk reduction depending on gene polymorphisms:
    • Genes/SNPs (single nucleotide polymorphism):
      • Gene: MTHFR _C677T (MTHFR).
      • SNP: rs1801133 in the gene MTHFR _C677T
        • Allele constellation: CC (lower risk if the allele constellation is present in the mother).
        • Allele constellation: TT (lower risk if the allele constellation is present in the mother).
• Periconceptional folic acid supplementation (four weeks before conception (i.e., if you wish to have a child) to eight weeks after: 0.4 mg/d = 400 μg/d orally) – this leads to a risk reduction of up to 70%.