Pediatrics in Brevard: Take this advice to reduce risk of birth defects before, during pregnancy

The New Year is a time to evaluate and to take steps to improve our lives.

Obviously, birth is the ultimate new beginning, and it is appropriate that this month is National Birth Defects Awareness Month.

As we begin 2024, we can take steps to reduce the incidence of birth defects in our families and communities, giving a healthy platform for a promising future to our next generations.

Birth defects affect one in every 33 babies born in the USA each year, and are the leading cause of infant deaths.

Not all birth defects are preventable, but many are.

According to the International Journal of Medical Sciences, up to 83.5% of long-term problems from birth defects can be prevented.

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Some birth defects can be completely avoided, and there are others that can be treated at birth to prevent long term problems if diagnosed early on.

This makes avoidance of risk factors along with perinatal care critically important.

There are 3 main causes of birth defects: genetic, environmental and multifactorial.

We will review each of these causes and discuss what we can do as a community to reduce the risks of them.

Genetic birth defects

Genetic birth defects are due to a problem with the DNA, or genome.

These can be inherited from parents or can be a new mutation.

Sadly, older parental age is associated with an increased risk of genetic defects.

Parents over the age of 35 years have a slightly higher risk, the odds are a little higher at age 40, and very significantly increased at age 44.

While the mother’s age plays the greatest role, the father’s age also has an impact.

Couples who are older and want to have children shouldn’t be discouraged; the risk of a genetic birth defect is still very small.

However, for those planning to start a family, it may be best to try to not delay past the age of 35 or 40 years.

The risk of a genetic birth defect is also significantly increased by consanguineous marriage (marriage of close relatives).

Further, use of tobacco by either parent prior to conception has been linked to genetic birth defects.

Environmental birth defects

Environmental birth defects are due to factors outside of genetics that impact a developing baby.

There are several things a parent can do proactively to reduce the risk of birth defects.

For example, lack of certain nutrients is known to cause defects.

Supplementation with folic acid and multivitamins has been shown to significantly reduce the risk of brain and spine defects, cleft lip/palate, heart defects and urinary defects.

For this reason, a prospective mother should start supplementation with at least 400mg of folic acid and a multivitamin at least a month before trying to get pregnant.

Many countries (including the USA) have begun to add supplemental folic acid into their foods, and have seen a decrease as high as 71% in the number of brain/spine defects in their countries.

A mother’s diet should be rich in fruits and vegetables as well as foods with omega acids such as eggs, avocado, nuts and fish (but avoid fish that may be contaminated with mercury).

Omega acids are good for brain development, in particular.

Maternal obesity has also been linked with an increased risk of birth defects, so healthy nutrition may reduce this risk as well.

Another thing a prospective mother can do to protect her baby is to be fully immunized against diseases that could cause birth defects such as measles, German measles and chickenpox.

Ask your gynecologist about vaccines you can get to protect your baby.

Mothers with diabetes should seek to maintain the best control of their blood sugars possible.

Multifactorial birth defects

There are some things to avoid during pregnancy.

For example, there is no known safe dose of alcohol for a fetus.

Alcohol is a well-known teratogen that affects brain and facial development.

Along with potential genetic defects, tobacco causes tissue damage in the unborn baby and has been linked to lung problems, brain defects, cleft lip, low birth weight and other defects.

Carbon monoxide in tobacco smoke can also keep the developing baby from getting enough oxygen.

Marijuana use has also been shown to cause low birth weight and neurological defects, even if the active ingredients are just applied to the mother’s skin topically.

The pregnant mother should also avoid getting overheated.

Exposure to high temperatures during the first trimester have been linked to heart defects, for example.

For this reason, pregnant mothers should avoid hot tubs and saunas, and should treat any fever with acetaminophen (which has been shown to reduce the risk of fever-related birth defects).

Always ask your gynecologist, though, about treating your fever or any other condition during pregnancy!

Infections can sometimes cause birth defects.

It is thought that infections cause about 2-3% of all birth defects.

Germs that are known to sometimes cause birth defects are: toxoplasmosis, HIV, syphilis, Fifth disease, chickenpox, Zika virus, rubella, cytomegalovirus, and herpes simplex virus.

Some of these can be prevented by immunization. Toxoplasma can be avoided by cooking meats well, washing fruits and vegetables, avoiding untreated water, wearing gloves while gardening and avoiding eating undercooked oysters, mussels or clams.

Cats can sometimes shed toxoplasma, so pregnant moms should not change the litter box, if possible, or touch stray cats. Wearing a mask may help prevent a pregnant Mom from picking up infections from settings such as schools or large gatherings.

Certain medications or supplements could potentially cause birth defects, as can some pesticides.

A prospective mother should always discuss any medications or supplements with her gynecologist to determine possible risks or benefits to the baby and should try to avoid pesticide exposure.

In summary, many birth defects can be avoided.

Healthy nutrition and supplementation with folic acid and a multivitamin can significantly reduce the risk of several types of birth defects.

Avoidance of alcohol, tobacco (in any form), marijuana and other recreational drugs further reduces the risk.

Measures to prevent infection for the pregnant mother is important as well; these include immunization, regular hand washing and the wearing of a mask and gloves in certain situations.

Proper follow-up and screening through her health care team can help a pregnant mother avoid some potential risks, and can help pick up on problems that a developing baby may have so that the condition can be more effectively treated at the beginning.

As a community, we can become more educated and look for ways to reduce these risks.

Dr Mary Ulrich is a board-certified Pediatrician at Pediatrics in Brevard, Melbourne office. Dr. Ulrich is also the medical director for Aveanna Prescribed Pediatric Extended Care facility in Melbourne as well as the medical director for Space Coast Early Steps.

This article originally appeared on Florida Today: Birth defects have 3 main causes: genetic, environmental, multifactorial