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Nutrition and oral health
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
Good nutrition even before pregnancy has a positive impact on children's health. Taking folic acid before pregnancy (as well as during pregnancy) Inadequate intake of folic acid is known to contribute to neuro developmental of babies, leading to spina bifida.
The Genetic Risk of a Couple Aiming to Conceive
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Joe Leigh Simpson, Svetlana Rechitsky, Anver Kuliev
Ideally, pre-conception identification of risk could lead directly to the primary prevention of occurrence of affected offspring. An excellent example is maternal administration of a vitamin (folic acid) pharmaceutical agent (2). Maternal administration of folic acid reduces the incidence of spina bifida by 75%, but few other examples have had such an impact. A major impediment to this approach is that, in the United States, half of all pregnancies are unplanned. Even when a pregnancy is planned, aspiring parents rarely query in advance with regard to applicable, preventative measures. Before implantation, pre-implantation genetic testing (PGT) can select a euploid (PGT-A) embryo or an embryo lacking a mutant monogenic genotype (PGT-M).
Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
A differential diagnosis of certain pathologies can be made depending on age. In children, the spectrum of disease is quite different from adults. Growth-related disturbances, such as deformities of the spine and spondylolisthesis,1 are common in children. Spina bifida can be diagnosed in a newborn. Back pain in a child younger than 4 years is usually caused by either an infection or a malignancy. Children in the first decade of life commonly present with discitis and osteomyelitis and primary orthopedic neoplasms. Patients older than 10 years are most likely to have back pain secondary to trauma, spondylolysis, disc herniations, or apophyseal fractures. Scheuermann’s kyphosis manifests in adolescence. Inflammatory arthritis, like ankylosing spondylitis and juvenile rheumatoid arthritis, commonly present in the adolescent age group.2
The prevalence and risk factors for foot pressure ulcers in ambulatory pediatric patients with spina bifida
Published in Disability and Rehabilitation, 2021
Susan Rethlefsen, Nicole Mueske, Tishya Wren, Rajan Murgai, Melissa Bent
The prevalence of spina bifida among children and adolescents in the United States was estimated at 3.07 per 10 000 in 2002 [1]. Spina bifida is a complex medical condition, requiring life-long care by multiple medical specialists including neurosurgeons, orthopedists, urologists, physical and occupational therapists, and hospitalizations are common. The median cost of hospitalization for an individual with spina bifida was estimated at ∼$10 000 for the year 2013 [2]. Pressure ulcers are the third most common reason for hospitalization in adults with spina bifida [3]. A large study of pressure ulcers in the general pediatric population followed in out-patient settings showed an overall prevalence of 1.72% [4]. The prevalence of skin breakdown is much higher in patients with myelomeningocele of all ages and functional levels at between 15–82% [5–9], and nearly 14% specifically in pediatric patients [10].
Postural Stability in Children with High Sacral Level Spina Bifida: Deviations from a Control Group
Published in Journal of Motor Behavior, 2020
Kardelen Gencer-Atalay, Evrim Karadag-Saygi, Samaya Mirzayeva, Ibrahim Gokce, Adnan Dagcinar
Bilateral hip flexion, extension and abduction, knee flexion and extension, ankle dorsiflexion, and plantar-flexion strength of all participants were measured using a dynamometer by the same physician. For a standardized measurement, the limb was positioned so as to provide maximum contraction for each muscle (Roy & Doherty, 2004). The participant was asked to exert maximum strength against the dynamometer for 5 sec, and the highest score was recorded. The strength of each muscle was measured thrice with an interval of at least 1 min, and the average value was calculated. The five times sit-to-stand test (5STS), 6-minute walk test (6MWT), and Pediatric Balance Scale (PBS) were used to evaluate gait and balance functionally. Static and dynamic postural stability were assessed by Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), Sit to Stand (STS), Walk Across (WA), and Step Up and Over (SUO) tests of the NeuroCom Balance Master® device (NeuroCom International, Clackamas, OR, USA). Spinal, hip, and ankle deformities in patients with spina bifida were detected by radiographic evaluation.
Pregnancy outcomes of women with spina bifida
Published in Disability and Rehabilitation, 2019
Nathalie Auger, Laura Arbour, Mireille E. Schnitzer, Jessica Healy-Profitós, Geneviève Nadeau, William D. Fraser
In addition to preterm and low birth weight, prior studies have considered the possibility of maternal transmission of neural tube defects to offspring [1,2,6,7]. In our study, there was no compelling evidence that women with spina bifida had an increased risk of neural tube defects in their infants. Prior reviews suggest that this group has a high risk of having pregnancies complicated by neural tube defects, potentially due to genetic errors of folate metabolism [1,2,4]. However, one review pointed out that evidence of maternal transmission of spina bifida has never been documented [1]. Indeed, in a case series of 17 women with spina bifida with 23 successful pregnancies, no infant was born with spina bifida, though three had other defects [7]. Another issue is that women who receive a diagnosis of neural tube defect in the second trimester frequently have abortions [20]. While less is known on use of abortion in women with spina bifida, research has shown that women with disabilities tend to have similar abortion rates as other women [21]. It is therefore possible that a large proportion of women with spina bifida choose to have abortions, lowering the ability to detect interpretable associations with neural tube defects.