Around 75 expectant parents in Switzerland are still confronted with the diagnosis of spina bifida every year – too many and unnecessarily, as became clear at a press conference in Zurich. Because by a once daily administration of folic acid already BEFORE and during pregnancy, the neural tube in the fetus can be closed in time. Prevention work is therefore crucial.
Pregnant women should take a multivitamin and mineral supplement in consultation with their doctor, because the increased requirements during and after pregnancy cannot be covered by food alone. Iodine deficiency can lead to a higher incidence of abortions, intrauterine fetal death, malformations, cretinism, and goiter; vitamin B12 deficiency can lead to serious hematologic and neurologic disorders. Vitamin A deficiency, according to Ravit Rubenov, a practicing physician in Dietikon, “can lead to malformations of the lungs, eyes, heart malformations and malformations in the urinary tract system,” and folic acid deficiency can promote neural tube defects such as spina bifida or anencephaly and heart malformations.
Therefore, the FOPH recommends, among other things, supplementation with folic acid in tablet form. Folic acid should be taken at least one to three months before and at least until the end of the first trimester of pregnancy, because already between the 18th and 26th day after fertilization a part of the cells forms the precursor of the nervous system, the neural plate, from which the neural tube develops. Nevertheless, only every second woman in Switzerland is aware of the positive effects of such supplementation before and during pregnancy.
National Council against bread enrichment
In order to shake up the population of Switzerland, Erich P. Meyer, initiator and managing director of the Foundation Folic Acid Offensive Switzerland, informed in Zurich about the reasons for the neglect of folic acid in Switzerland: “The prevention of a motion to enrich bread cereals with folic acid in Switzerland was unfortunately successful in the National Council.” In fact, in 75 countries around the world (including the U.S.), folic acid is added to bread cereals of all kinds so that every woman and man nationwide has a normal or slightly elevated folic acid level even before they want to have children – and with success, as rates of spina bifida cases have dropped by 25-75% in these countries. According to Erich Meyer, enriching bread in Switzerland would only cost around CHF 100,000 per year.
Nevertheless, the National Council opposes it, among other things because enrichment is seen as a coercive measure. Erich Meyer is convinced: “There is no better way than to fortify bread cereals with folic acid.” The Folic Acid Foundation continues to advocate this.
Maria Walliser, President of the Swiss Folic Acid Foundation and former ski racer, told the press conference about life with her now 21-year-old daughter Siri, who was born with an open back. She advocated taking folic acid before pregnancy without fail, but also made the case for not labeling folic acid as just a supplement for pregnant women: “Folic acid is a life vitamin, in fact it also improves sperm quality and cognition!”
The view of the doctors
At the conference, Nicolas Graber, general manager of EFFIK, a pharmaceutical company specializing in gynecological preparations, presented recent results of an online survey of 50 Swiss gynecologists on the most important nutritional supplements during pregnancy.
The 50 survey participants treat an average of 21 pregnant women per month. They prescribe nutritional supplements for pregnant women during 8.6 months. 32% believe that nutritional supplements for pregnant women are particularly useful in cases of fatigue, while 68% consider the supplements useful for all pregnant patients.
For doctors, however, a good dietary supplement includes not only folic acid (76%). Supplementation with vitamin B12 (94%), iron (94%), calcium (92%), magnesium (92%), vitamin D (84%) or iodine (80%) is also considered particularly important for a healthy pregnancy.
Séverine Bonini
Source: Press lunch on folic acid, Zurich, July 3, 2013 (Organizer: EFFIK SA).
