YAKIMA, Wash. — State health officials have uncovered a disturbing spike in a deadly spinal cord birth defect in Yakima County, prompting the local health district to encourage pregnant women to be even more vigilant about healthy behaviors.
Anencephaly is a defect in which the protective neural tube surrounding the spinal cord does not close properly at the top of the spine. Based on national statistics, the state Department of Health expected Yakima County to have only one case of the defect for the county’s 4,000 or so births. But for 2012, officials have found eight cases.
The defect is “uniformly fatal,” said Dr. Chris Spitters, the public health officer for the Yakima Health District.
The neural tube should close around the spinal cord by the fourth or sixth week of a woman’s pregnancy, he said. In most cases of anencephaly — about 75 percent — the fetus is stillborn. If it does survive birth, the baby dies within a few hours or days.
The defect falls under the “mandatory reporting” requirement for health facilities, so hospitals must report to the state all cases of anencephaly. However, Health Department spokesman Donn Moyer said, there is no specific analysis conducted on those reports, so the department can’t say how many cases were reported statewide last year or how many cases Yakima County saw in previous years.
“We don’t have solid numbers or data on statewide rates — just one of those things there’s not enough resources for,” Moyer said. “It’s there in case somebody wants to look at it.”
Health care providers in Yakima County noticed an apparently higher incidence last year and contacted the state Health Department with their concerns. Officials started digging and found eight total cases.
The state has just begun its investigation to look for more cases and determine possible causes, making it too early to cite any one reason for the increased rate of the defect, Spitters and Moyer said. Investigators will be looking at data for past years and following up to see if more cases went unreported to determine if 2012 was just a random spike or evidence of a new trend.
Anencephaly is similar to another spinal cord defect, spina bifida, in which the neural tube fails to close properly at the base of the spine. Spina bifida frequently results in paralysis, but can sometimes be helped with surgery early in the child’s life.
Spitters said the most conclusive studies show a direct link between neural tube birth defects and the mother’s intake of folic acid.
A diet rich in folic acid, which is found in leafy green vegetables, legumes like beans and peas, citrus fruits and fortified grains, is “something that all women can do,” he said.
“It may certainly prevent a lot of neural tube defects and may be protective, even, if other risk factors are present,” Spitters said.
All women of childbearing age are recommended to take a vitamin that includes folic acid, he said.
Beyond that, he said, early prenatal care as soon as pregnancy is recognized is essential, along with early testing to determine the health of the fetus.
Some smaller studies have shown that there may be a contaminant in cornmeal that’s linked to anencephaly.
Similar small studies indicate that higher levels of nitrates in drinking water could also contribute.
To that end, health officials say, it’s crucial for families who use private well water to get their water tested for nitrates and act accordingly if the levels are found to be higher than what the federal government says is safe.
“We’re looking at everything,” Moyer said, adding that anencephaly seems to be most often caused by a combination of factors.
Yakima County has poor health rates in several areas, including diabetes and obesity, which both contribute to risk factors for anencephaly. Access to health care — including prenatal care — is also a recurring problem in the Valley, providers and health officials say.
In the course of the state’s research, “It may be that the factors found are correlated with socioeconomic status; it may not,” Spitters said.
• Molly Rosbach can be reached at 577-7728 or firstname.lastname@example.org