No matter how deeply a mother
cares for her unborn child, there's no guarantee her
baby will be born in perfect health. Birth defects are
more common than you might think, and they're not always
avoidable.
One in 33 infants in
the United States is born with a birth defect, according
to the National Birth Defects Prevention Network (NBDPN).
Although genetic factors play a role, the causes of
most birth defects remain a mystery, the group says.
But there are simple
steps a woman can take to boost the odds of bearing
a healthy child. That's the message the NBDPN wants
women, their partners and health-care providers to heed
this January, designated as National Birth Defects Prevention
Month.
"What we try to do is
educate women about having a healthy pregnancy to prevent
any type of birth defect," said Denise Higgins, chairwoman
of the group's education and outreach committee.
For example, women are
advised to take folic acid at least a month before planning
to become pregnant. Folic acid, or folate, is a B vitamin
necessary for proper cell growth. Studies show it can
decrease the risk for neural tube birth defects, including
spina bifida, a leading cause of childhood paralysis,
and anencephaly, a fatal condition in which parts of
the brain and skull cap are missing.
About 2,200 babies are
born with neural tube defects each year in the United
States, according to the March of Dimes.
It's important to get
enough folic acid before becoming pregnant because the
neural tube -- the part of the embryo that becomes the
brain and spinal cord -- develops in the first couple
weeks of pregnancy. Forty percent of American women
of childbearing age now get enough of the vitamin to
help prevent birth defects, according to a 2004 March
of Dimes survey. That's up from 32 percent the previous
year -- a sharp increase, but far from the majority.
On Jan. 24, the National
Council on Folic Acid is launching National Folic Acid
Awareness Week to make people aware of the many benefits
of this vitamin.
The U.S. Public Health
Service urges all women of childbearing age to take
a multivitamin containing 400 micrograms of folic acid
every day. Folic acid pills and most multivitamins sold
in the United States have 100 percent of the daily value
of folic acid, according to the U.S. Centers for Disease
Control and Prevention, but women should read the label
to be certain.
Women who have previously
had a child with a neural tube defect need even more
folate: 4 milligrams daily before conceiving and during
the pregnancy is recommended, says Dr. Diane Ashton,
associate medical director of the March of Dimes.
Women also are advised
to abstain from drinking alcohol at any time during
their pregnancy. Alcohol can cause fetal alcohol syndrome
(FAS), a lifelong condition characterized by abnormal
facial features, growth retardation and central nervous
system problems. Children with FAS may have physical,
mental, social and behavioral problems.
As many as one in 1,000
children born in the United States each year suffers
from fetal alcohol syndrome, the NBDPN says. And prenatal
alcohol-related conditions, including alcohol-related
neurodevelopmental disorder and alcohol-related birth
defects, are believed to occur three times as often
as fetal alcohol syndrome, the CDC notes.
"There's no healthy amount
of alcohol a woman can drink," Higgins cautioned. "We
don't know if one drink causes fetal alcohol syndrome
or being an alcoholic does, so the message is, 'Don't
drink.'"
Studies show even "social
drinking" -- a drink or two a week -- may have adverse
effects on the fetus, Ashton said. Yet many women are
not getting the message. "And it's really important
for their health-care provider to be able to convey
that information to them," she said.
If you are pregnant,
you will most likely have a simple blood test called
an alpha fetoprotein (AFP) test to screen for fetal
abnormalities, including spina bifida and anencephaly.
More invasive testing, including chorionic villus sampling
and amniocentesis, is generally reserved for women 35
and older, or whose AFP results suggest a higher risk
for birth defects.
Whether women under 35
should request invasive testing depends entirely on
their preferences, said Miriam Kuppermann, an associate
professor in the Department of Obstetrics, Gynecology
and Reproductive Sciences at the University of California,
San Francisco, who has studied the cost effectiveness
of invasive testing.
"If they are interested,
they should request clear information on the likelihood
that they are carrying an affected fetus and the miscarriage
risk of the procedure, as well as on other testing options,"
she said. Women who desire such testing should get an
appointment with a genetic counselor to review the risks
and benefits.
If you're planning to
become pregnant, talk to your doctor about any health
concerns you have. Women with diabetes and epilepsy,
for example, are at greater risk of having a baby with
a neural tube defect, Ashton said.
Also, ask your doctor
about any medications you are taking. Certain acne and
seizure medicines have been linked to birth defects,
Higgins explained.
No one should have to
suffer the heartache of having a child with a serious
birth defect, so prenatal care experts encourage women
to discuss any concerns they have with their health-care
provider ahead of time.
"Preconception counseling
is very important," Ashton said.
More information
The U.S. Centers for
Disease Control and Prevention has more about preventing
birth defects.
