Nausea and Vomiting in Early Pregnancy Increases Risk of Neural Tube Defects
According to a new study in Scientific Reports, nausea and vomiting during early pregnancy (NVP) is associated with an increased risk in neural tube defects.
What are neural tube defects? According to the March of Dimes, the United States non-profit that works to improve the health of mothers and babies, neural tube defects are defined as the following:
Neural tube defects (NTDs) are birth defects of the brain and spinal cord. They happen in about 3,000 pregnancies each year in the United States.
A baby’s neural tube normally develops into the brain and spinal cord. It starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. NTDs happen if the tube doesn’t close completely. NTDs can cause serious problems for babies, including death.
If women of childbearing age take 400 micrograms of folic acid every day before and during early pregnancy, it may help reduce their baby’s risk for NTDS. Folic acid is a B vitamin that every cell in your body needs for normal growth and development.
The three types of neural tube defects:
1. Spina bifida:
Spina bifida is the most common neural tube defect. Spina bifida affects approximately 1 out of every 1000 births. When the child is born, the small bones of the vertebrae do not close completely. As a result, a part of the ever important spinal cord is exposed through the lower portion of the spine. These vertebrae are unfused and open.
Spina bifida malformations fall into three categories: occult, cystic with meningocele, and cystica with myelomeningocele. The latter, myelemeningocele, is the most common form and leads to disability in most affected individuals.
Encephalocele, also known as cranium bifidum, is a characterized by sac like protrusions of the brain through openings in the skull. Encephalocele affects 1 out of every 5,000 births. Again, this defect is caused by the failure of the neural tube to close completely during development. Encephalocele is characterized by the appearances of encephaloceles, grooves down the middle of the skull, on the back side of the skull, or between the forehead and the nose. The severity of encephalocele depends on the location of the encephaloceles.
Encephalocele, sometimes known by the Latin name cranium bifidum, is a neural tube defect characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull. These defects are caused by failure of the neural tube to close completely during fetal development. Encephaloceles cause a groove down the middle of the skull, or between the forehead and nose, or on the back side of the skull. The severity of encephalocele varies, depending on its location. Children generally need surgery to place the brain back into the skull.
Approximately 20% of children with encephalocele are stillborn. 75% of children of who survive with encephalocele have lasting learning disabilities. The remaining 25% may have normal intelligence.
Anencephaly is considered the most severe neural tube defect. Anencephaly affects affects 1 out of every 10,000 births. Children who suffer from anencephaly are missing major parts of their brain, skull, and scalp. The vast majority of children do not survive long after birth, typically just a few hours.
Anencephaly occurs when the neural tube fails to close, typically between the 23rd and 26th day of conception. Girls are 3x more likely than boys to have anencephaly.
NVP and its risks in relation to miscarriage and negative outcomes:
Many studies have demonstrated that NVP is associated with a decreased risk of miscarriage. However, severe NVP (including hyperemesis gravid arum) is associated with low birth weight and increased risk of fetal growth retardation.
Overview of the study:
The study examined nearly 1000 women, 459 women for the case group and 459 for the control group. In the case group, a total of 194 anencephaly, 200 spina bifida, and 65 encephalocele.
Results of the study:
A higher level of NVP, or morning sickness/hyperemesis gravidarum was correlated with a higher likelihood of neural tube defects. The study reported that morning sickness in pregnant women was strongly correlated with reduced intakes of protein and micronutrients. Consequently, this lack of a healthy diet affected infant outcome as well as maternal weight gain during pregnancy.
Additionally, the case-control study showed that severe or moderate NVP has an association with the risk of neural tube defects which was not replicated in the group of intake of folic acid supplements. As such, folic acid supplements are strongly recommended within three months before pregnancy or in the first trimester to reduce probability of neural tube defects.
Women suffering from morning sickness or hyperemesis gravidarum should increase consumption of protein and micronutrients during pregnancy. Furthermore, it is particularly important that women consume, at a minimum, 400 mcg of folic acid, or folate, per day. Since NVP already increases chances of neural tube defects, it is extremely important that women utilize folic acid supplements to offset the risk of neural tube defects. Folic acid can reduce incidence of neural tube defects from women suffering from NVP.
Pink Stork products provide an excellent way to alleviate nausea and vomiting during pregnancy. Further, our products provide complete prenatal health, including folic acid via our Folate product, which is completely sourced from organic lemon peels. Our Program Overview, which you can download for free here, recommends best dietary practices as well, such as eating clean, sustainably raised protein sources and micronutrients, two recommendations in-line with the authors’ conclusions.