Most babies are born healthy, yet the National Birth Defects Prevention Network (NBDPN) estimates that one in 33 infants enters the world with some sort of birth defect. January is Birth Defects Prevention Month, and women are urged to take proactive steps to help ensure a healthy baby.
“A lot of things should start before a woman gets pregnant—not after,” emphasizes Dr. Amy Flick, a maternal fetal medicine specialist at SSM St. Mary's Health Center. She notes that the first trimester of pregnancy is a crucial developmental stage, although many women are unaware they are pregnant for some time after conception. That’s why being tobacco and alcohol-free, taking appropriate supplements, and following a healthy diet are key for any woman who may become pregnant.
The NBDPN advises women to take 400 micrograms of folic acid daily from the beginning of menstruation through menopause. “Folic acid is involved in numerous metabolic processes within the body, and deficiencies of folic acid or abnormalities of the metabolic processes that utilize folic acid have been associated with birth defects,” says Dr. Jim Bartelsmeyer, director of the Mercy Maternal and Fetal Health Center. Most multivitamins contain at least the recommended amount of folic acid.
“The strongest association between folic acid and birth defects is with spina bifida or neural tube defects,” Bartelsmeyer says. A neural tube defect indicates a problem with the spinal cord or its coverings, and spina bifida occurs if the fetus’s spinal column fails to close completely during the first month of pregnancy. “Not all neural tube defects can be prevented with folic acid supplementation because there are other factors (i.e., genetic) involved. But supplementation with folic acid can prevent 50 to 70 percent of all neural tube defects,” he adds.
Bartelsmeyer also urges women who want to conceive to see an obstetrician prior to pregnancy to discuss specific risks and lifestyle modifications. This is especially beneficial for women who have a family history of birth defects or have a chronic illness, such as diabetes, that can increase risk. Discussion of environmental factors and medications also helps ensure the woman is prepared for a healthy pregnancy and baby.
Once a woman becomes pregnant, regular prenatal care and recommended screenings are important for identifying any potential problems and planning for them. For instance, Flick notes that if a fetal heart defect is suspected, specialists will be consulted to perform additional tests and address any concerns at the baby’s birth.
It is important to remember that not all birth defects are life-threatening or disabling. In many cases, birth defects are cosmetic, such as cleft lips, and can be successfully treated. “Major birth defects that are potentially life-threatening affect 1 to 2 percent of children at birth, but many major birth defects are not diagnosed at birth,” Bartelsmeyer says. “The incidence goes up to 6 percent at 1 to 2 years of age due to delayed diagnosis. The most common organ systems affected are cardiovascular (heart), orofacial (cleft lip), spine (spina bifida or neural tube defect), brain (hydrocephalus), gastrointestinal tract, urinary tract and abdominal wall.”
Even given such a grim list, Bartelsmeyer notes that overall risk is very low for healthy women who maintain a healthy lifestyle, and most parents welcome healthy babies.