Moderate category and the rarest case of the disorder is called the Spina Bifida Meningocele which are divided into two conditions, the posterior and anterior Meningocele, the most common of Meningocele is the posterior form in which the protective membranes (meninges) are slightly coming outward through the opening split of spine shaping a sac (University of Virginia Health System, 2007). Eventough the meninges are pushed outward, the sac however does not enclose any nerves, only cerebral-spinal fluid can be found inside the sac produces a less probability of the spinal cord to grow inappropriately (Spina Bifida Association of America, 2008). The second condition, anterior Meningocele affects the inner faces of the vertebrae where the sac obtrudes the prelude space (Spina Bifida Association of America, 2008).
The most severe, and more common case of cystic Spina Bifida named as Myelomeningocele also known as meningomyelocele or open Spina Bifida, in contrast to Meningocele the individual’s spinal column remains open along several vertebrae in the lower or middle back (Spina Bifida Association of America, 2008). The cyst in the opening spine no longer contain cerebral-spinal fluid only, nerves, tissues, and parts of the spinal cord are incorporated as well, in some cases the skin covers the cyst still tissues and nerves are exposed to the outer environment making it more prone to life-threatening viruses (Scottish Spina Bifida Association, 2008). As a result of this specific condition, there will always be a paralysis, lost of sensation, and bowel and bladder problem, Myelomeningocele would cause the individual to have a hydrocephalus causes the head to enlarge with the skull bones expanding than normal as the result of the built up CSF inside the head giving more pressure inside the head (University of Virginia Health System, 2007).
Maternal nutritional factors are regarded as the most significant involvement to the complex of Spina Bifida causes specifically foremost amongst all is the supplement of folic acid (Blom, Shaw, Heijer, & Finnell, 2006). Scientists’ evidence based proposes the underlying idea of maternal immune system reaction towards folate’s flow of transportation, in understanding the proposing idea; scientists found maternal auto-antibody tied to folate receptors resulting of the blocking the intracellular folate uptake by target epithelial cells which consequently cause Spina Bifida (Blom, Shaw, Heijer, & Finnell, 2006). This proposing theory is in favour of the advantageous effect of supplementary folate intake. In support of this idea, the lack of folate which is accessible to the embryogenesis development to a flawed or blocked increased concentration has been major attributed to fortification of food rather than vitamin supplements (Blom, Shaw, Heijer, & Finnell, 2006). Folic Acid is the artificial form of folate used in vitamin supplements and to fortify foods, whereas folate is the natural form of vitamin B-9 component naturally occurring in foods (Morbidity and Mortality Weekly Report, 2007).
Folate inside the cell acts as the acceptor and donor of one carbon unite presented on the wide range of oxidized and decreasing the form of one-carbon moiety, the one carbon-unit is provided by two forms of amino acid and effectively used in the production of DNA building-block in which the cycle of the metabolism of folate is guaranteeing the sufficient amount of methylation compounds, thus folate metabolism is necessary cellular functioning particularly during the growth period (Blom, Shaw, Heijer, & Finnell, 2006).
Apart from the fundamental cause of folic acid and folate in the role of Spina Bifida, genetic factor plays elementary basis of perceptive in the risk factor of Spina Bifida. Research has shown where mothers whom give birth to Spina Bifida baby have a superior amount of Homocysteine concentration although these mothers have sufficient level of folate during their time of pregnancy (Blom, Shaw, Heijer, & Finnell, 2006). Homocysteine is a genetic control, under special circumstances the strong manufactures of homocysteine could influence in outcome lessening of the folate metabolism rate, stream, and pile up (Blom, Shaw, Heijer, & Finnell, 2006). Having inadequate effective DNA which cause Spina Bifida which occurring only in the spinal cord is outlining in the stage of neurolation when the completion and closure of spinal cord happen on the 28th day of pregnancy, by this period if failure taking place, then DNA may not be effective as the spinal column has fully developed (Blom, Shaw, Heijer, & Finnell, 2006).
Neurotransmitter called nitric oxide functioning as the core aspect of an indicator for other molecules which mediate many biological effects inside human system, has been associated as one of the genetic factors in Spina Bifida since nitric oxide is presence during neurolation inside the neural tube balancing between mitosis and cell death (Linden, Heil, Heijer, & Blom, 2007). As the researchers stated the presence of nitric oxide may interfere with enzyme activity and homocysteine and proper neurolation (Linden, Heil, Heijer, & Blom, 2007).
Besides from genetic factors, race and ethnicity is another risk of Spina Bifida. Research has publicized in which the prevalence of Spina Bifida in the US amongst all the race and ethnicity, the chances are higher in Hispanic women compared with other races (Morbidity and Mortality Weekly Report, 2007). US mainland has intensified on the importance of dietary supplements containing folic acid for most women who are planning to have babies, daily intake of 400 mg before conception could reduce the risk of Spina Bifida (Morbidity and Mortality Weekly Report, 2007). In relation to the Asian context, Asian female babies have higher prevalence on Spina Bifida, since the Westerners have amplified laws on the importance of folic acid (Morbidity and Mortality Weekly Report, 2007).
The outcome of Spina Bifida is so divergent and various since the causes of Spina Bifida is not rooted to one main factor, it is a combination between the environment and genetic factors which influence the occurrence of Spina Bifida (University of Virginia Health System, 2007). Therefore, the multifactorial traits need to be taken into account when we look at the outcomes of Spina Bifida. However, Spina Bifida is a serious problem in which it involves the major and foremost part of the human functioning, which are the brain and spinal cord noted in which these two parts are the fundamental of every single nerves, and cells are connected to and where the brain is the vital part where all the neurological activities taking place (University of Virginia Health System, 2007). Hence, when the foremost parts of all neurological activity occurs with the additional of the nerves and tissues being exposed to the surrounding, it is ordinary if the outcomes of Spina Bifida are so divergent.
References
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Blom, H. J., Shaw, G.M., Heijer, Md., and Finnell, R. H. (2006). Neural Tube Defects and Folate : Case Far From Closed. Nature Reviews Neuroscience, 7, 724 – 731. Retrieved February 18, 2009 from EBSCO database.
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Linden, I. J. Mv., Heil, S. G., Heijer, Md., and Blom, H. J. (2007). The 894G>T Variant in the Endothelial Nitric Oxide Synthase Gene and Spina Bifida Risk. Journal of Human Genetics, 52, 516 – 520. Retrieved February 20, 2009 from EBSCO database.
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Morbidity and Mortality Weekly Report. (2007). Folate Status in Women Childbearing Age by Race/Ethnicity – US, 1999 – 2000, 2001 – 2002, and 2003 – 2004, 55, 1377 – 1380. Retrieved February 20, 2009 from EBSCO database.
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Morbidity and Mortality Weekly Report. (2007). Trends in Folic Acid Supplement Intake Among Women of Reproductive Age - California , 2002 – 2006, 56, 1106 – 1109. Retrieved February 20, 2009 from EBSCO database.
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National Institue of Health. (2007). NINDS Spina Bifida Information Page. Retrieved February 15, 2009 from the world wide web :
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Spina Bifida Association of America . (2008). Are There Any Different Type of Spina Bifida. Retrieved February 16, 2009 from the world wide web :
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Scottish Spina Bifida Association. (2008). Scotland’s Voice for Spina Bifida, Hydrocephalus, and Related Condition. Retrieved February 15, 2009 from the world wide web :
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University of Virginia Health System. (2007). High Risk – Newborn, Spina Bifida. Retrieved February 15, 2009 from the world wide web :
