1. Spina Bifida and Fertility Amy Houtrow, MD, PhD, MPH Associate Professor of Physical Medicine & Rehabilitation and Pediatrics University of Pittsburgh

2. Parents Often Ask

3. The Answer

4. Fertility and Spina Bifida Women with spina bifida tend to have normal fertility meaning that they can get pregnant If a pregnancy isn’t wanted, women with spina bifida who are sexual active should use birth control. – Non-latex condoms can be used as birth control and as a method of protecting against sexual transmitted infections – Other birth control options should be discussed with a doctor

5. Fertility and Spina Bifida If pregnancy is desired, women with spina bifida should see a Obstetrician who specializes in high risk pregnancies before getting pregnant Plans need to be made for – Taking folic acid 4mg/day – Addressing current medications – Monitoring the pregnancy – Delivery

6. Genetic Considerations Unlike some conditions, there isn’t one gene for spina bifida The cause of spina bifida is likely from interactions from multiple genes that get modified by environmental factors. Some things increase the risk of spina bifida – Diabetes – Obesity – High fever very early in pregnance – Having or having a close relative with spina bifida – Certain medications – Folic acid deficiency

7. Genetic Considerations 2 out of 10,000 babies born each year will have spina bifida Risk of having a baby with spina bifida For a person with spina bifida 5-10% For a person with a 1 st degree relative with spina bifida 3-5% For a person with a 2 nd degree relative with spina bifida 1-2%

8. Helpful Articles Epidemiologic and genetic aspects of spina bifida and other neural tube defect – By KS Au, A Ashley-Koch, H Northrup – In Developmental Disabilities Research Review 2010; 16 (1): pgs 6-15 Sexuality Issues in Adolescents with a Chronic Neurologic Condition – By KJ Sawin, CF Buran, TJ Brei, PS Fastenau – In the Journal of Perinatal Education 2002; Winter, 11(1): pgs 22-34.