Child's desire and pregnancy: why take vitamin B9

Child's desire and pregnancy: why take vitamin B9

Once you are pregnant, even before you become pregnant, supplementation with folic acid (or folate, or vitamin B9) is recommended. A deficiency in this vitamin can indeed be at the origin of serious malformations of the nervous system of the fetus such as spina bifida. The ideal is to start the supplementation at the earliest because the nervous system develops from the first weeks of pregnancy.

Every year in France, 800 pregnancies are affected by poor neural tube closure in developing fetuses *. This risk could be greatly reduced if all women of childbearing age expressing a desire for a child were supplemented with folate (or folic acid ), also known as vitamin B9.

THREE OUT OF FOUR WOMEN LACK VITAMIN B9

Folic acid is naturally present in certain foods such as fish livers, yeast, egg yolks and dark green leafy vegetables (cabbage, spinach, lamb's lettuce, broccoli ...). But the recommended daily dose is 400 micrograms, which represents 15 broccoli or two lettuce a day! The appropriate dose is as high as five milligrams for obese women ( BMI > 30) or with a history of neural tube closure abnormalities.

Nearly three-quarters of women of childbearing age have folate dietary intakes below 100% of recommended dietary intakes and 7% of women of childbearing age have a serious folate deficiency. However, according to data from the Eurocat network (European Surveillance of Congenital Anomalies), 90% of pregnant or child-desire women are not properly supplemented with folic acid.

NEURAL TUBE CLOSURE ABNORMALITY: ONE IN 1,000 BIRTHS

Inadequate vitamin B9 intake in the mother may play a role in fetal nervous system abnormalities related to a defect in central nervous system formation: this is what doctors call the tube closure anomaly neural. The defect will occur at the level of the spine, between the base of the skull and the low end (the sacrum). Most frequently, this type of abnormality is at the origin of pathologies such as spina bifida, a congenital disease responsible for a loss of sensitivity in the limbs and paralysis, but also the encephalocele (brain which develops in outside the cranial box) and anencephaly (partial absence of brain). A prenatal diagnosis by ultrasound can detect such abnormalities.

However, " even if four out of five women choose a medical abortion in this case, some refuse and the children who are born are severely disabled, " says François Haffner, president of the National Association Spina Bifida and Handicaps Associés . " These children will need multiple surgeries and hospitalizations throughout their lives - the cost of a person reporting such illnesses is extremely high both financially and humanely: these patients will suffer from orthopedic problems, cognitive impairment, sphincter disorders leading to urinary incontinenceand faecal very disabling for social development, sexual disorders but also symptoms of depression and bad living. The consequences on family and professional life are very heavy, "says François Haffner, in France, one child per 1,000 births is infected with spina bifida, but supplementation of the mother with vitamin B9 makes it possible to reduce this proportion to 0, 3 babies per 1,000 births.

AT LEAST ONE MONTH BEFORE BEING PREGNANT

The vitamin B9 pathway is therefore particularly interesting in reducing the incidence of these nerve diseases: " the risks of neural tube closure anomalies are due to several factors: environmental pollutants , genetic factors, and folate deficiencies. It is on this last point that we can do the most "insists doctor Thierry Harvey, obstetrician gynecologist at the hospital Diaconesses Croix Saint-Simon, in Paris.

But as the development of the nervous system is very early in the fetus (between 21st and 28th day of pregnancy), folate supplementation should begin at least one month before conception , which is not always obvious, " the The problem is that it should be given to women who wish to become mothers at the right time, that is, at least one month before they become pregnant, yet one in two women has not scheduled their pregnancy. "stresses François Haffner. So to act on time, Dr. Harvey says : " Any contraceptive consultation should be a preconceptional consultation, that is, any woman who has contraception that she can stop herself ( pill ,, ring ) should be fully informed about emergency contraception as well as about folic acid supplementation when contraception is discontinued if there is a desire for pregnancy. According to Dr. Harvey, before the pregnancy, as soon as the desire to get pregnant points the tip of the nose, " women should benefit from a consultation that allows a review of the health of the future mother (weight, smoking). , vaccination ...) for preventive purposes "to minimize risks to the baby.