San José, Costa Rica, since 1956

Costa Rica Reduces Cases Of Spina Bifida in Newborns

COSTA Rica reduced the annualnumber of cases of spina bifida in newbornsby 31.5% from 1999-2003, thanksto the addition of vitamins and folic acidin the food that women of reproductiveage eat, as well as dietary supplements,officials announced this week.Spina bifida is a neural tube defectthat happens in the first month of pregnancywhen the spinal column doesn’tclose completely. According to the SpinaBifida Association of America, the effectsof the condition vary – up to 90% of childrenwith the worst form of spina bifidahave hydrocephalus (fluid on the brain)and must have surgery to insert a “shunt”that helps drain the fluid – the shunt staysin place for the lifetime of theperson. Other conditions include full orpartial paralysis, bladder and bowel controldifficulties, learning disabilities,depression, allergy to latex, and socialand sexual issues.Costa Rican health authorities considerthe reduction an important achievementbecause after congenital heart disease,deformation is the highest cause ofinfant mortality.While in 1999 there were 54 registeredcases of newborns with defects inthe neural tube caused by spina bifida, in2003 there were only 37, according to theCosta Rican Institute of Education,Nutrition, and Health.The rate of defects of the neural tubewas 9.42 for every 10,000 newborns in1999, and 5.07 in 2003.In comparison, spina bifida occursin 7 of every 10,000 live births in theUnited States, according to the SpinaBifida Association.The decrease in Costa Rica can likelybe attributed to measures that enrichwomen’s diets with vitamins and folic acid,such as with supplements and their additionto flour, corn flour, rice and milk.Since April 2003, the Costa RicanSocial Security System (Caja), whichmanages public health care, has suppliedfolic acid pills to more than 1 millionwomen ages 15-49 throughout the country,the daily La Nación reported.“The neural tube closes on the 27thday of a fetus’ development,” geneticpediatrician Lila Umaña told La Nación.“Therefore, it’s important to emphasizethe supplementation of folic acid beforeand after conception, especially in thefirst days. This reduces the risk that thechild is born with problems up to 80%.”

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