January is National Birth Defects Prevention Month, a time for raising awareness of how frequently birth defects occur and what can be done to help prevent them. This year, the theme is “Making Healthy Choices to Prevent Birth Defects – Make a PACT for Prevention.” In this article, Medical News Today will explore precisely how a PACT can be made.
Birth defects are conditions that are present when a baby is born and can affect nearly every part of the body. Some conditions such as cleft lip can be easy to diagnose, while others – such as deafness or heart defects – may only be discovered following diagnostic testing.
Each year in the US, around 120,000 babies are born with birth defects – one every 4.5 minutes. In total, birth defects affect 1 in 33 babies born in the country and are the cause of 1 in 5 infant deaths during the first year of life.
According to March of Dimes, birth defects are not only common and critical, they are also costly. Each year, birth defects-related hospital costs in the US exceed $2.6 billion.
Birth defects are caused by a variety of different factors that can lead to conditions forming at any stage of pregnancy. Genetic inheritance, individual behavior and environmental factors can all work together to result in birth defects.
The following is a list of 10 of the most common birth defects in the US, according to the Centers for Disease Control and Prevention (CDC):
- Down syndrome – 6,037 cases a year
- Cleft lip (with or without cleft palate) – 4,437 cases a year
- Cleft palate without cleft lip – 2,651 cases a year
- Atrioventricular septal defect (hole in the heart) – 1,966 cases a year
- Absence of malformation of the rectum and/or large intestine – 1,952 cases a year
- Gastroschisis (hole in the abdominal wall) – 1,871 cases a year
- Tetralogy of Fallot (a combination of heart defects) – 1,657 cases a year
- Spina bifida without anencephaly – 1,460 cases a year
- Reduction deformity, upper limbs – 1,454 cases a year
- Reversal of the heart’s two main arteries – 1,252 cases a year.
“Birth defects can have a serious physical and emotional impact, not only on those affected, but also on their families and communities,” says Coleen Boyle, director of the National Center on Birth Defects and Developmental Disabilities.
With these points in mind, preventing birth defects can have a widespread positive effect.
Experts do not know what causes more than 60% of birth defects, though they are aware there are certain measures that can be taken in order to reduce the risk of their occurrence.
“Although not all birth defects can be prevented, there are steps women can take to increase the chances of having a baby born without birth defects,” explains Leslie Beres, president of the National Birth Defects Prevention Network (NBDPN). “Small steps like visiting a health care provider regularly and consuming 400 micrograms (mcg) of folic acid daily before and during pregnancy can go a long way.”
The “P” in PACT stands for planning ahead. If a mother wishes to have a healthy baby, it is best to start preparing prior to conception. The majority of birth defects occur during the first 3 months of pregnancy, when the baby’s organs are forming, so being prepared from the get-go can improve a baby’s chances.
According to the CDC, around half of pregnancies are unplanned. As a result, all women of childbearing age are recommended to follow advice to ensure the best possible health for babies.
- Asparagus, cooked, 1 cup: 243 mcg
- Beef liver, braised, 3 ounces: 215 mcg
- Black-eyed peas, boiled, ½ cup: 179 mcg
- Lentils, boiled, ½ cup: 179 mcg
- Broccoli, cooked, 1 cup: 168 mcg.
Health care professionals identify folic acid – also referred to as folate – as being incredibly important for healthy babies. Folic acid is a B vitamin that reduces the risk of neural tube defects affecting the brains and spines of babies.
If all pregnant women took 400 mcg of folic acid each day during the initial stages of pregnancy, up to 70% of neural tube defects could be prevented.
Such is its importance, the Food and Drug Administration (FDA) stated in 1996 that all grain products labeled as “enriched” had to have folic acid added to them.
Since this mandate – known as folic acid fortification – was passed, a 36% reduction in cases of spina bifida and a 17% reduction in cases of anencephaly (incomplete formation of the brain, skull and scalp) have been recorded.
Genetic counseling can also be an important part of preparing for a healthy pregnancy. Geneticists help people to learn about genetic conditions and find out what the likelihood would be of their child being born with a genetic birth defect, as well as advise screening for genetic conditions.
The “A” in PACT stands for avoiding harmful substances. Harmful substances include drugs such as alcohol and tobacco, as well as substances that can be found in the environment, workplace or home.
As stated earlier, almost half of pregnancies in the US are unplanned, meaning that babies can be inadvertently exposed to harmful substances before the mother is aware of being pregnant.
In addition to causing birth defects, harmful substances can have other severe consequences including premature birth, sudden infant death syndrome (SIDS) and miscarriage. They can also affect a woman’s health and ability to become pregnant.
According to March of Dimes, smoking during pregnancy causes 20% of oral clefts (lips and palates). Even if a woman smokes before realizing she is pregnant, quitting can still improve the chances of her baby avoiding certain health problems, such as low birth weight.
Some jobs involve exposure to fumes or toxic metals that can be hazardous to the health of unborn children. These should be avoided where possible; ask questions about such hazards in the workplace or consult a doctor if you have any concerns.
Good forward planning is the best way to prevent harmful substances from affecting the health of unborn children. Even if pregnancy does not occur, avoiding harmful substances is beneficial to overall health enough to make this worthwhile.
The “C” in PACT stands for choosing a healthy lifestyle. “A mom’s health during pregnancy has a direct impact on her baby’s health,” says Dr. Siobhan Dolan, medical advisor to the March of Dimes. “There are many things a woman can do to help give her baby the best opportunity to be born healthy.”
There are many other things that women can do to live a healthy life and reduce the risk of the baby developing a birth defect. Key to choosing a healthy lifestyle is following a healthy diet, maintaining a healthy weight and treating long-term conditions such as diabetes.
The babies of women who are overweight have an increased risk of birth defects. Overweight mothers also have an increased risk of miscarriage and complications related to delivery and labor.
Following a healthy diet is crucial to achieving and maintaining a healthy weight, and any changes in diet need to be long-term rather than viewed as a quick fix. A diet rich in fruits, vegetables, whole grains, low-fat dairy, lean proteins and healthy fats and oils is recommended by the NBDPN.
Diabetes can affect the chances of a baby being born with a birth defect if it is not controlled properly. Blood sugar needs to be kept at a healthy level. As many people are unaware that they have this metabolic disease, seeking testing from a doctor may be a good idea for women who are unsure.
Gestational diabetes is a form of diabetes that affects 2-10% of pregnant women, occurring when the body is unable to produce enough insulin to cope with the increased demands of pregnancy. Living a healthy lifestyle could halve this risk, according to study reported by Medical News Today in October 2014.
There are many infections a mother can catch that can increase the risk of birth defects. These include:
- Sexually transmitted diseases (chlamydia, gonorrhea, syphilis)
- Vaccine-preventable diseases (rubella, flu)
- Food-borne infections (listeria, salmonella).
The risk of catching these infections can be easily reduced by paying close attention to personal hygiene, making sensible lifestyle choices and getting appropriate vaccinations. However, all potential shots should be discussed with a doctor due to the potential for adverse effects.
“Eating a healthy diet and working toward a healthy weight, keeping diabetes under control, quitting smoking and avoiding second hand smoke and avoiding alcohol – all can help increase the chances of having a healthy baby,” says Leslie Beres.
The “T” in PACT stands for talking to your doctor. Regular contact with a doctor can greatly help with planning ahead, avoiding harmful substances and choosing a healthy lifestyle.
All medications should be discussed with a doctor prior to being taken, including prescription medication, over-the-counter medication and dietary and herbal supplements.
Use of opioid-based painkillers in early pregnancy could double the risk of babies being born with serious heart defects, and other pain medication can also lead to spina bifida or gastroschisis – a hole in the abdominal wall.
Vaccination history should be discussed with a doctor. There are some vaccinations that are best received before becoming pregnant, such as the measles, mumps and rubella (MMR) vaccine. Others such as Tdap – for whooping cough – should be received during pregnancy.
The flu vaccine is best given at specific times, depending whether it is flu season when pregnancy begins or not. Researchers have found that a flu shot given during pregnancy can protect both mother and baby (for up to 6 months) from flu. Pregnant women are more susceptible to severe illness caused by flu.
An important part of planning a pregnancy can be exploring family history. This process is best done with the assistance of a doctor, who can help to identify any relevant information that may influence care during pregnancy. A doctor may recommend specific genetic or nutritional counseling depending on a family’s medical history.
Pregnant women should have regular check-ups – referred to as antenatal care – arranged with a doctor or midwife. These are vital in monitoring the health of both mother and baby and identifying any health risks that may arise as soon as possible.
Men can also play a part in preventing health defects, even if a lot of the onus is on women to maintain a healthy lifestyle. Offering support to people who are considering parenthood can make a difference, particularly when significant lifestyle changes, such as quitting smoking, are involved.
The American Pregnancy Association (APA) state that raising awareness of Birth Defects Prevention Month – by sending an email to everyone in your address book, for example – could help. “It is free and could easily prompt someone considering parenthood to have a wellness exam or seek genetic counseling,” they suggest.
As some birth defects can run in the family, it is important that men participate fully in any investigations into family medical history that take place.
In recent years, Medical News Today has reported on studies suggesting that a father’s diet and occupation can also influence the risk of birth defects in their infants.
These studies have suggested that men should ensure they receive adequate levels of folate, and men working in certain jobs – including computer scientists, landscapers and hairdressers – were associated with a higher risk of having children with birth defects.
Even if the findings of these studies have not been incorporated into the recommendations of groups such as the NBDPN, if men decide to make similar lifestyle changes to their partners, they could provide an additional level of encouragement that might make big changes a little bit easier.
Birth defects are a widespread health issue, but it does not have to be as prevalent as it is. One of the keys to lowering its prevalence is through raising awareness.
“Many people don’t realize how common birth defects are,” says Coleen Boyle. “Most of us know someone affected by these conditions: a child born with cleft lip and palate, a young girl with Down syndrome, a co-worker who has lost a baby due to a severe heart defect.”
National Birth Defects Prevention Month is well placed at the start of the year. The majority of recommendations for reducing birth defects are linked to living a healthy lifestyle. With the turn of the year fresh in people’s minds and impetus for change in the air, January is a great time for people thinking about children to build the foundations for a happy and healthy pregnancy.
“The New Year will be full of surprises,” says Dr. Dolan. “So even if you’re not pregnant, but want children in the future, resolve to give them a healthy start in life.”