Preventing Birth Defects, Complications
Most congenital abnormalities are of unknown cause, but simple steps can minimize the risks
Doctors don't know what causes the majority of birth defects nor what parents can do to foolproof their offspring. But a study published this week, which noted a connection between children with defects and mothers who are obese, underscores the fact that expecting parents are far from powerless.
"One in 40 pregnant women, no matter what she's done, is going to have a baby with a birth defect," says Michael Greene, a Harvard professor and spokesperson for the American College of Obstetricians and Gynecologists. According to the Centers for Disease Control and Prevention, 70 percent of birth defects have no known cause. But with about 4 million annual births, that still leaves tens of thousands of defect-plagued births each year that could be prevented.
The best way to deliver a healthy child, says Edwin Trevathan, director of the National Center on Birth Defects and Developmental Disabilities at the CDC, is to plan for it—and take the necessary steps before getting pregnant.
But since more than half of pregnancies in the U.S. are unplanned, experts advise all women of reproductive age to follow a healthy lifestyle, whether or not they are planning on having a baby. "The time to focus on this is long before women become pregnant," Trevathan says. Here's what he and other experts say women should do if they might become pregnant.
Maintain a healthy weight. This week's study, led by Kim Waller at the University of Texas-Houston, found that children with a variety of birth defects are 1.3 to 2.1 times as likely as healthy children to have a mother who is obese. Does that mean the mothers' excess pounds caused the birth defects? Not necessarily, but the study is the latest of several showing a link between maternal obesity and a class of congenital problems called neural tube defects, according to Harvard's Greene. Since experts don't recommend dieting during pregnancy, women are encouraged to get to as healthy a weight as possible before they get pregnant.
Get folic acid. Scientists don't know why, but taking folic acid dramatically reduces the rate of neural tube defects such as spina bifida. "The single most important thing a woman can do to prevent birth defects is to take folic acid," says Greene. The tricky thing about the vitamin is that it's needed very early in pregnancy—before most women know they're pregnant. That's why health professionals encourage all women of reproductive age to supplement their diet with a multivitamin containing 400 micrograms of folic acid. Folate, a natural form of folic acid, occurs in leafy green vegetables, and the synthetic vitamin is added to most grain products.
Avoid alcohol. Excessive alcohol consumption is one of the leading causes of preventable birth defects, according to the CDC. Each year, 40,000 babies are born with fetal alcohol syndrome and a related group of disorders called fetal alcohol spectrum disorders. Since scientists haven't established a safe level for alcohol exposure, public health experts advise pregnant women to avoid booze entirely and to avoid drinking heavily if they might become pregnant. That said, if a woman had a glass of wine or two a week before she knew she was pregnant, she shouldn't worry, Greene says.
Quit smoking. "There is absolutely nothing about smoking that is positive," says Katz. "Any woman of reproductive age ought not to smoke if she wishes to have a healthy child." Although there's no proven link between smoking and particular birth defects, tobacco use is associated with a greater risk of miscarriage, premature birth, and low birth weight, says Greene.
Get a checkup. A woman who's thinking about pregnancy should visit a doctor, experts say. The consultation can help her determine whether any medication she's taking might post a risk to a fetus. And getting health conditions like diabetes under control before a pregnancy begins can help prevent problems, says Greene. Moreover, certain infections, such as rubella, chickenpox, toxoplasmosis, and cytomegalovirus, can be dangerous to a pregnant woman or her baby. "Have a doctor check your immune status," recommends Karen Filkins, a retired doctor and former spokesperson for the American College of Obstetricians and Gynecologists who is an expert on birth defects. She says that knowing whether a woman is immune to chickenpox, for example, can help her determine whether she needs to get a vaccine or take other precautions.