Birth defects abate

N.C. has fewer spina bifida cases

Anna Williamson was a rarity even before she was born.

Still in her mother's womb in 2000, she was diagnosed with spina bifida, a birth defect in which the spinal column does not fully close. Her parents chose to have Anna undergo experimental fetal surgery to close the opening.

Today Anna is 7 and shows nearly none of the hallmark disabilities of the birth defect, which often results in lower-body paralysis that affects walking, bowel control and other functions.

Now she is even more of a rarity, as fewer and fewer babies across North Carolina are born with the birth defect.

State data released this month show that rates of spina bifida and other neural tube defects have declined at least 40 percent since 1995, tracking national reductions in the defects.

Spina bifida alone is down at least 45 percent. In Western North Carolina, where rates of the birth defect were particularly high, spina bifida declined more than 80 percent.

Public health experts credit successful efforts to increase folic acid intake.

Breads and cereals have been fortified with folic acid since the mid-1990s in accordance with U.S. Food and Drug Administration recommendations. And state and national public awareness campaigns now push the need for all women of childbearing age to take vitamins that supply at least 400 micrograms of folic acid a day.

Folic acid is a B vitamin that is required to produce and maintain new cells. During periods of rapid growth, such as pregnancy, the body needs more of it. Supplementing the vitamin can prevent up to 70 percent of neural tube defects.

"Women have a higher baseline level of folate in their systems, and those neural tube defects are just being prevented," said Amy Mullinex, coordinator of the N.C. Folic Acid Campaign, a statewide initiative to raise awareness of the importance of folic acid.

Anna's parents, Jason and Susan Williamson of Holly Springs, think their family's story, which The News & Observer told in 2000, also has helped -- even though folic acid did not protect their daughter.

Susan Williamson was well aware of the benefits of folic acid when she and her husband began planning their family. She took more than twice the daily recommended amount for about two years before she became pregnant with Anna. The Williamsons were stunned when, 18 1/2 weeks into the pregnancy, they learned that Anna had developed spina bifida in spite of the precaution.

"It obviously helps, but it can't prevent everything," Susan Williamson said.

Still, she said Anna's story helped educate women about spina bifida and folic acid, which is the only effective means of prevention.

"We've had so many people who saw the story say, 'I didn't know about folic acid,'" Williamson said.

The Williamsons have helped in other ways.

They have been an ambassador family for a March of Dimes fundraising dinner. Their family -- which has grown to include three other children without spina bifida -- is part of a genetic study at Duke University on neural tube defects. From time to time, they speak to expectant parents facing a diagnosis of spina bifida.

Jason and Susan Williamson also wrote an article, published a few years ago in an international medical journal, aimed at helping health systems better serve parents seeking treatment for children with congenital birth defects.

The Williamsons said they hoped fetal surgery would lessen Anna's disability and reduce the need for further surgeries after her birth. It has delivered on both counts.

Anna is paralyzed only in her right ankle and toes. She can run, jump, ride a bicycle and even play basketball. She was potty trained by age 3. She has not had surgery since she was in her mother's womb.

"Anna was given a very determined personality," said Susan Williamson. "There is not much that stops her from doing what she wants to do. It's amazing to me the things she can do."