Birth defects occur in approximately 2 to 4 percent of livebirths. Marisol Flores, MD, who is an Ob/Gyn and Assistant Area Medical Director for Kaiser Permanente, shares what they have learned about birth defects and how women can improve their chances of having a baby born without a birth defect.
Dr. Marisol says, “A birth defect is a condition that is present at birth. Some birth defects are caused by the parents’ genes. Others result from problems with chromosomes (too many, not enough, deleted, or relocated chromosomes).”
Birth defects are caused by a complex mix of factors. We don’t fully understand how these factors might work together to cause birth defects. “A small number can be caused by exposure to medications, infections, and chemicals during pregnancy, and for many birth defects (50-70%), the cause is unknown. Every pregnancy starts with a 3-5% chance of having a birth defect (also called background risk),” adds Dr. Marisol.
Risk factors
Here are some risk factors that place pregnant patients at a higher risk for birth defects.
- Family or personal history of birth defects.
- Older age (advanced maternal age considered 35 and older).
- Having a previous child with a birth defect.
- Obesity (defined as having a body mass index [BMI] of 30 or greater). The most common obesity-related birth defects are neural tube defect (NTD), heart defects and cleft palate.
- Medical conditions such as diabetes, high blood pressure and seizure disorders.
- Using recreational drugs and alcohol.
Common types of medications that are known to cause birth defects and should be avoided are:
- Pain relievers
- Laxatives
- Cold and allergy
- Herbal supplements
- Skin treatments (Isotretinoin)
- Lithium
- Warfarin
Pregnant women often receive a prenatal diagnosis from a variety of techniques, both invasive and non-invasive, when they are provided prenatal care. The techniques are employed to determine the health and condition of the developing fetus. Dr. Marisol shares, “Birth defects are, for the most part, diagnosed prenatally after an obstetrical ultrasound. When there is a high suspicion of a birth defect, blood tests to check for infections and genetic screening are recommended. Sometimes, amniotic fluid is obtained to rule out infections and chromosomal abnormalities.”
Prevention
We know that not all birth defects can be prevented. But we also know that women can increase their chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. “Most birth defects cannot be prevented since most defects are of unknown cause,” says Dr. Marisol. Some actions that can prevent birth defects are:
- It is recommended to see your doctor before getting pregnant to review your health condition and understand how you can decrease your risk of birth defects. Taking care of your medical conditions before pregnancy and transitioning (if needed) to medications that are safe during pregnancy is especially important.
- Overall healthy habits such as healthy eating, exercising, adequate sleep, and stress-reducing techniques.
- Taking multivitamins before and during pregnancy. Taking 400 micrograms of folic acid daily at least one month before pregnancy helps prevent neural tube defects. These are defects of the brain and spine of the fetus.
- Avoiding alcohol. Alcohol is known to cause birth defects, especially targeting the fetal brain, which develops throughout the 40 weeks (about 9 months) of pregnancy. There is no known safe level of alcohol during pregnancy. Exposure to alcohol during pregnancy can cause fetal alcohol spectrum disorders, life-long physical defects, intellectual learning and behavioral difficulties.
- Avoid marijuana use. Marijuana has been associated with gastroschisis, which is a rare birth defect in which the infant’s intestines slide out of an opening in the abdominal wall.
- Do not use illegal drugs or prescription drugs for a nonmedical reason.
- Prevention of infections such as Rubella, Toxoplasmosis, Sexually Transmitted Infections (STIs), Cytomegalovirus, Zika, and Flu.
- Avoid harmful agents such as lead, mercury and elevated levels of vitamin A (more than 10,000 units per day).
Dr. Marisol explains, “a developing fetus is most vulnerable to birth defects during the embryo stage when organs are developing. For example, substance or chemical exposure can cause the greatest injury to a fetus between two and ten weeks after conception”.
Treatment for birth defects will depend on the type of defect. For example, an extra digit can be surgically removed, or a cleft palate or some heart defect can be repaired. Defects from infection or chromosomes involve defects in multiple organs, which may be a life-long problem.
Babies who have birth defects often need special care and interventions to survive and thrive developmentally. Early intervention is key. If your child has a birth defect, you should ask his or her doctor about resources and treatment.