Nutrition + Metabolic: Neural tube defects (prevention in pregnancy)

Question 1

Neural tube defects represent a group of congenital defects, caused by incomplete closure of the neural tube within how many days of conception?

Answer 1

Neural tube defects represent a group of congenital defects, caused by incomplete closure of the neural tube within 28 days of conception.

Question 2

What are the most common forms of neural tube defects? (3)

Answer 2

The most common forms are anencephaly, spina bifida and encephalocele.

Question 3

What are the main risk factors of neural tube defects? (7)

Answer 3

1. Maternal folate deficiency
2. Maternal vitamin B12 deficiency
3. Previous history of having an infant with neural tube defect.
4. Smoking
5. Diabetes
6. Obesity
7. Use of AEDs

Question 4

Pregnant women or women who wish to become pregnant should be advised to take supplementation with ____ ____ before conception and until week __ of pregnancy.

Answer 4

Pregnant women or women who wish to become pregnant should be advised to take supplementation with folic acid before conception and until week 12 of pregnancy.

Question 5

What dose of folic acid is recommended for prevention of neural tube defects in a woman who smokes?

Answer 5

5 mg daily, to be taken before conception and until week 12 of pregnancy. HIGH RISK.

Question 6

What dose of folic acid is recommended for prevention of neural tube defects in a woman who has a BMI of 28?

Answer 6

400 micrograms daily, to be taken before conception and until week 12 of pregnancy.

Obese = high risk, obesity = 30 or above bmi

Question 7

What dose of folic acid is recommended for prevention of neural tube defects in a woman who has taken hydroxycarbamide in the past?

Answer 7

Hydroycarbamide is teratogenic in animal studies.

If the patient is no longer taking the hydroxy but was taking it in the past for sickle-cell disease then it is recommended she take 5 mg daily, to be taken before conception and until week 12 of pregnancy. HIGH RISK.

Question 8

What dose of folic acid is recommended for prevention of neural tube defects in a woman who uses a Bydureon 2mg powder and solvent for prolonged-release suspension for injection pre-filled pen?

Answer 8

Bydureon = exenatide which binds to, and activates, the GLP-1 (glucagon-like peptide-1) receptor to increase insulin secretion, suppress glucagon secretion and slow gastric emptying.

Diabetes is a risk factor for neural tube defects so she should take 5mg daily before conception and for up to 12 weeks.

Question 9

What dose of folic acid is recommended for prevention of neural tube defects in a woman who takes 8mg of perampanel at night?

Answer 9

Perampanel: adjunctive treatment of focal seizures with or without secondary generalised seizures.

Antiepileptic drugs = high risk, she should take 5,g daily before conception and for up to 12 weeks.