The Importance of Folic Acid in the Prevention of Neural Tube Defects (NTDs) in Women [Interview][Transcript]

Dr_Lisa_Mastrson_Neural_Tube_DefectsGuest: Dr. Lisa Masterson
Presenter: Neal Howard
Guest Bio: Doctor Lisa Masterson is a national expert in the areas of obstetrics, gynecology, infertility, adolescent gynecology and family planning. Dr. Masterson is affiliated with UCLA Medical Center, Santa Monica and has 24 years of experience.

Segment overview: Lisa Masterson, MD, discusses everything women should know about the role of folic acid in preventing Neural Tube Defects (NTDs).

Transcription
Health Professional Radio – The Importance of Folic Acid

Neal Howard: Hello and welcome to Health Professional Radio, I’m your host Neal Howard, thank you for joining us today. It’s especially important for those considering becoming pregnant to know that every year in the United States, thousands of infants are born with neural tube defects, defects like spina bifida. Our guest today is a former co-host on The Doctors, Dr. Lisa Masterson, she’s an expert in an area of obstetrics, gynecology and fertility and family planning. She’s here today to talk about the role that folic acid place in preventing NTDs. Welcome to the program, doctor.

Dr. Lisa Masterson: Thank you so much for having me.

N: Thank you. NTDs spina bifida I’ve mentioned it, are there other NTDs?

M: Anencephaly which involves the brain and hydrocephalus. There is a wide spectrum of the things that involve the neural tube defects. But you hit right on folic acid, which can really decrease the risk of neural tube defects or NTDs and so it so important that women know that once they are of childbearing age, they should be taking a multivitamin with folic acid. All women should be taking multivitamins with folic acid to help prevent neural tube defects because we know that half of the pregnancy in the United States are unplanned. Ideally, in an ideal situation, it will be great if women who are planning to get pregnant would go to their doctor and get a preconception consultation and we could individualize their care. They have special needs like the need to make lifestyle changes ahead of time or we need to switch their medicine then that could be done then but a lot times that doesn’t happen and we know that folic acid is a huge player in neural tube defect. So if women would either get the preconception counselling and they can do that ideally or just at least all women of childbearing age arm themselves with a multivitamin with folic acid.

N: Are there other steps that can be taken to help prevent NTD’s?

M: Yes, folic acid a lot of the cereals are folic acid fortified and that’s the help but what we know that you can’t guarantee the dosage of it, but then a get a folic acid just from your diet. That is why it is still so essential for woman to take actually a multivitamin with the certain amount of folic acid, which is the standard dosage. They have a higher risk of neural tube defects because of their family history, if they have previous childhood neural tube defects, if they have diabetes, if they’re obese, if they have malabsorption disorders or if they take seizure medication that decreases the absorption of folic acid, they actually need to take a higher dosage of folic acid and that’s one reason why I’m really thrilled to be here today. Auditioning USA and talk about imparity 4 and 5 because it actually has a higher dosage. A lot of women don’t realize and that’s again why if we didn’t get them into the doctor before they actually get pregnant, they can plan. They may not realize that they’re at higher risk and actually need a higher dosage of folic acid than the standard to prevent neural tube defects.

N: This month all the way from the 8th through the 14th of this month has been designated as folic acid awareness week. We’re here talking about the importance of folic acid for the preconception health. When is the best time to start on the folic acid trail? Are we talking adolescence, pre-teen or when you’re trying to get pregnant?

M: All women of childbearing age, that’s basically when girl starts their period there’s possibility of getting pregnant, she should actually get on folic acid. The best window to say a woman is thinking about getting pregnant then we advise at least 2 or 3 months before she gets pregnant so that it gets in her system. If you’re planning to get pregnant then she should, again, really be on it 2-3 months before she gets pregnant. That’s the reason behind as doctors warn you because for preconception consultation so that we can tell you when to start doing before you actually get pregnant. But, yes childbearing age means from the time your period starts and essentially the time your period stop, you’re taking multivitamins with folic acid.

N: In your experience, how long have we known about this important connection, folic acid as a preventive measure for NTDs?

M: It’s actually been for quite a while. I’m not sure, I think we’re just about getting it out to public because I’m still really always surprised. I still have my friends as well as my patients who will come to me and their nearly pregnant and ask me what should be they taking. This is why I’m doing this today because it’s not too late for them in the rest of their pregnancy but to prevent the neural tube defects which occur early in pregnancy, then you should have actually started prenatal multivitamins or a folic acid supplement at least 2-3 months ago for your ideal. But if you still want to be on it for the rest of the pregnancy and the health of the pregnancy as well as your development and all of that. It’s never too late to start taking it or start prevention for neural tube defects. If you started during the pregnancy it’s not as beneficial as if you started beforehand.

N: Can an enhanced intake a folic acid reverse maybe some of the detrimental effects of say, drinking or smoking? In general, and especially during pregnancy, should those things be stopped regardless of whether your folic acid intake has increased or not?

M: They should be stopped regardless, yes. You definitely if you want it, even if you decrease the amount of cigarette that you smell, ideally we want them to stop. There’s another reason why preconception counselling is really good because we’re there again to support pregnant women if they have alcohol addiction or drug addiction or smoking, to help them stop those things safely and use alternative medication if we have you to. These are to support and not to judge. It’s really important that these advices tell is to come up that women to comfortable and bringing them up so that we can help them ideally stop before they get pregnant but even during pregnant it actually helps the pregnancy as well. It is helpful in addition to having a folic acid.

N: I do understand that the checklist for preconception health does include avoiding contact with toxic materials that could cause an infection at work or home. Is an infection part of the onset of any NTDs?

M: The Zika virus has been associated with that. Yes, there are viral things that are associated with neural tube defects. That’s why a lot of people are just getting these awareness because the zika virus of neural tube defects when really it’s something that has been here all the time and something that we’ve able to prevent with folic acid, for the folic acid deficiency. Again, it should just drive home how important it is for women of childbearing age to take a multivitamin with folic acid.

N: Excellent information. You’ve been listening to Health Professional Radio, I’m your host Neal Howard in studio with Dr. Lisa Masterson, women’s health expert, in studio with us talking about the benefits of folic acid. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm, you can subscribe to this podcast on iTunes and also listen in Soundcloud.