Preventing Birth Defects - Part 2

Last week we talked about some of the causes of birth defects.  Today we are going to focus on things that you can do to lower your risk of having a baby born with birth defects.

Can all birth defects be prevented?

Unfortunately, not all birth defects can be prevented.  Although we have identified some definite causes, we don't know the cause of most birth defects, which makes it hard to predict all of them.

What can you do to help decrease the risk of birth defects?

Ideally, you should start planning to decrease your risk before you even get pregnant.  If your pregnancy is unexpected, start as soon as you find out that you are pregnant.  In general, a healthy mom is more likely to have a healthy baby.  Here are the recommendations:

• See your healthcare provider regularly.  Start prenatal care as soon as you think you might be pregnant.  
• Get 400 micrograms (mcg) of folic acid every day, starting at least one month before getting pregnant.  
• Don't drink alcohol.  Alcohol exposure during pregnancy causes brain damage and growth problems for the baby, which are not reversible.  
• Don't smoke.  Smoking and pregnancy: Understand the risks - Mayo Clinic
• Talk with your doctor about any medications you are taking, including over-the-counter medications, dietary or herbal supplements, as well as prescription medications.  Don't stop or start any type of medication without first talking with a doctor.
• Do your best to prevent infections during pregnancy.  (More details on this below.)
• Avoid elevated body temperature, which includes,
  • Be on the lookout for fever if you are sick or after you get a vaccine.  Fever higher than 101 degrees F should be treated with acetaminophen.
  • Avoid hot tubs, saunas, or other environments that might cause overheating.
• If you have underlying medical conditions, including diabetes or high blood pressure, use effective birth control until you are ready for pregnancy.  Be sure any medical conditions are under control before becoming pregnant.  If pregnancy is unexpected, see your doctor as soon as you suspect you are pregnant to make sure your medical conditions are controlled.  

What are the important infections you should know about if you are, or are planning to become,  pregnant?  How can you avoid them?

• Toxoplasmosis - Caused by the parasite Toxoplasma gondii, which can be found in undercooked, infected meat as well as cat feces.  Contracting this infection during pregnancy increased the risk of miscarriage, stillbirth, and birth defects such as deafness, blindness, cerebral palsy, and seizure disorder.  Avoid toxoplasmosis - Don't touch cat poop or cat litter boxes during pregnancy.  Thoroughly cook meats and wash hands after handling raw meat. 
• Rubella - A viral infection that is very dangerous to an unborn baby, especially in the first 12 weeks of pregnancy.  When a pregnant woman develops rubella infection during pregnancy, it can affect almost everything in the developing baby's body.  The most common birth defects are deafness, heart defects, cataracts, intellectual disabilities, liver and spleen damage, and low birth weight.  Avoid rubella - Anyone who is not vaccinated against rubella is at risk of getting this infection.  Make sure you have had your full MMR (measles, mumps, rubella) vaccine series.
• Listeriosis - Infection with the Listeria monocytogenes bacteria during pregnancy increases the risk of premature birth, miscarriage, and stillbirth.  This bacterium can be found in soft cheeses (like brie or feta), deli meats, and sometimes raw vegetables.  Avoid Listeriosis - Do not eat unpasteurized milk or soft cheeses.  Avoid eating the juices found in hot dog or deli meat packages.  Don't eat packaged, undercooked meat like pate.  Wash raw vegetables very well.  Reheat leftovers to the point that they are steaming.
• Cytomegalovirus (CMV) - A common viral infection, which can be spread through bodily fluids like urine and saliva.  It can cause birth defects such as hearing loss, seizures, and intellectual disabilities.  Avoid CMV - Don't share food or utensils with others.  Practice good hygiene and wash hands frequently, especially if you work in a daycare or healthcare setting.
• Zika Virus - A viral infection spread by certain types of mosquitos.  It can cause severe birth defects if a woman has the infection during pregnancy.  Birth defects can include microcephaly (small head size) and intellectual disabilities.  Avoid Zika Virus - When you are pregnant, it is very important to avoid traveling to places where there are current Zika outbreaks.  Stay up to date on Zika outbreaks by visiting the CDC website.  Avoid getting bitten by mosquitos!  Wear insect repellant, stay indoors during peak mosquito seasons and peak times of day that mosquitos are active.
• Chicken Pox - Chicken pox (varicella) is a very contagious viral infection.  If a pregnant woman contracts chicken pox during the first 20 weeks of pregnancy, it can cause birth defects such as small head size, intellectual disabilities, developmental delays, abnormalities of the eyes, arms or legs, and gastrointestinal abnormalities.  If chicken pox develops during the few days before the baby is delivered, the baby might be born with a potentially life-threatening infection called neonatal varicella.  Avoid Chicken Pox - If you don't think you have had chicken pox and have not been vaccinated, ask your doctor about getting vaccinated before pregnancy.  The vaccine is safe for adults, but it is recommended that you wait until three months after your second dose of the vaccine before trying to get pregnant.  If you are exposed to chicken pox during pregnancy and are not immune, contact your doctor immediately.  They might recommend an injection of an immune globulin product that contains antibodies to the chickenpox virus.

For more information about birth defects and how to prevent them, use these links:

https://www.birthdefectsresearch.org/primer/

Fetal alcohol syndrome - Symptoms and causes - Mayo Clinic

Commit to Healthy Choices to Help Prevent Birth Defects | CDC

If you have any questions about preventing birth defects, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Preventing Birth Defects

About 1 out of every 33 babies born in the US each year is born with a birth defect.  Birth defects range from minor abnormalities to critical, life-threatening conditions.  Let's talk about what they are and what women need to know to decrease their chance of having a baby born with a birth defect.

What are birth defects?

They are structural abnormalities that occur during a baby's development in the womb.  They can affect almost any part of the body and sometimes affect more than one part of the body.  They may be visible on the body, or they may be internal.  They can also affect the function of the body.  Some babies born with birth defects need surgery within the first few days of life in order to survive.  Some birth defects may also affect a person's expected life span.

How are birth defects identified?

Most birth defects are found within the first year of life; some are quite apparent at birth.  Some birth defects are minor or cause no significant functional limitations, and some may not be identified until much later.

Some birth defects are easy to see, such as a cleft lip or an extra finger.  Others require special tests to make the diagnosis, such as heart defects, which require an ultrasound of the heart, or hearing loss, which requires a hearing test to detect the problem.

Intellectual disability can also be a birth defect caused by factors occurring during pregnancy.

What causes birth defects?

While we do know the cause of some birth defects, for most birth defects, we don't know their cause.  We think they are caused by a complex mix of factors, which can include inherited genes, behaviors, and exposure to certain things in the environment.  

Most birth defects begin during the first 3 months of pregnancy, when a baby's internal organs are developing.  The first 3 months is a very important stage of development for the unborn baby.  Because the tissues and organs continue to grow and develop throughout pregnancy, birth defects can occur at any stage of pregnancy.  

Even though we still have a lot to learn, thanks to past research, we know a great deal about birth defects, including some definite causes of birth defects and some things that probably increase the chances of having a baby born with a birth defect.  

Here are some of the things that increase the risk of birth defects:

• Drinking alcohol, or taking certain drugs during pregnancy
• Smoking during pregnancy
• Taking certain medications 
• Family history of birth defects
• Having certain infections during pregnancy
• High body temperature in mother during pregnancy, due to fever or a high heat exposure
• Being an older mother, or sometimes having an older father, as the risk of chromosomal abnormalities increases with age.

These are the primary things that we know about.  Having one or more of these risk factors doesn't mean you will have a baby with a birth defect, but these factors do increase your risk.  Sometimes a baby is born with a birth defect when none of these risk factors are present.  This points to the complex nature of birth defects.  

Next week we will talk more about how you can prevent birth defects.  It is important to know what you can do to lower your risk.

If you have any questions about preventing birth defects, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor