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HealthCalling

Birth Defect Prevention

01-15-2018

In about 2-4 percent of all live births there will be a congenital malformation or a birth defect. A defect is considered any structural anomaly deviating from normal development. Some of them are as minor as an ear tag or an extra finger; and some of them are severe enough to require medication or surgery, according to Dr. Amy Richards, OB/GYN with Covenant Medical Group. She offers great information on how to prevent them, how to detect them, and what can be done if they are discovered.

Most common defects include heart defects and ​neural tube defects, or problems with the formation of the brain and spinal cord. Development of the baby occurs very early in pregnancy and some defects can occur before you would even know you are pregnant.

What to do pre-pregnancy (or as soon as you find out you are pregnant):

  • Review your medical history with a physician. If you have any medical conditions such as diabetes or thyroid disorders, get them well-controlled and/or review your medication list before becoming pregnant – some congenital defects come from medications or environmental exposures that we can prevent before conception occurs.
  • If you’re not using birth control, then being on a pre-natal vitamin is a great idea. Even if you’re not planning a pregnancy, a multivitamin does good things for your health; and if you do have an unanticipated pregnancy the benefit can be provided to the fetal development.
  • Pre-natal vitamins almost all have the recommended 400 mcg of folic acid daily. Some women may require up to 4 milligrams of folic acid depending on their medical history or medication list. It is also recommended to take a prenatal with DHA, which is an omega 3 fatty acid which helps with fetal eye and brain development. Most of the other vitamins in a prenatal vitamin are found in other multivitamins.
  • Women who discover they’re already pregnant can start taking a pre-natal vitamin right away. Folic acid has been proven to reduce the incidence of neural tube defects. More than 20 years ago the U.S. government began fortifying wheat and grain products, so that women who didn’t know they were pregnant – but were eating cereal, bread, or other grains would still be getting some folic acid supplementation.
  • It is recommended to be active and to optimize your weight before becoming pregnant. Once you’re pregnant, stay active; but you don’t want to try to lose weight or over-exert yourself. Making healthy choices in your diet is always going to help the health of the pregnancy. There are lots of resources to help people with their diet, to know what is healthy; website at choosemyplate.gov offers a lot of nutrition plan and proper balance in the diet.

What NOT to do:

  • Tobacco and illicit drug use is never recommended for your health, but definitely can have some serious ramifications when it comes to pregnancy and attempts should be made to quit prior to conceiving.
  • In studies on Fetal Alcohol Syndrome, there has not been an amount of alcohol determined to be safe, so it is recommended for anyone who could potentially be pregnant to abstain from alcohol use.

See or find a doctor as soon as possible:

  • As soon as you become pregnant (or find out you are) reach out to find an OB/GYN to care for you and the pregnancy, so you can review those risks that you may or may not understand to be risks early on in the pregnancy.
  • You may need to be on medications to optimize any health problems you have. For example if you have a history of diabetes, getting your blood sugars under control decreases the risk of both heart malformations and miscarriages.
  • Some medications can increase the risk for birth defects. I recommend reviewing your medications with your doctor to determine which ones are safe in pregnancy. You do not want to stop the medications without talking with a health professional as this could potentially do more harm than good. For example, women with epilepsy (a seizure disorder) who suddenly stop their medication are at increased risk to have a seizure. Should the woman seize this could be harmful to her health or the health of the pregnancy.

Testing and detection:

  • Once you become pregnant, there are a variety of genetic tests that can be done with ultrasound and/or bloodwork to look for any birth defects the baby might have. Genetic screening is always an option but never required of the mother. These tests do not diagnose defects, but may show an increased risk that one is there and further testing may be needed.
  • Some birth defects are not diagnosed until later in the pregnancy. Typically an ultrasound is done between 18-22 weeks (about 5 months) which screens for many birth defects that we are able to detect before birth.
  • The kind of abnormality that may be found impacts the care that is offered. Some babies will require surgery immediately after birth, many will just need monitoring or further tests by the pediatrician.

“A lot of people avoid going to the physician because they’re worried about finding out negative results or abnormalities,” Dr. Richards said. “But for most of the things we find, there are interventions or ways that we can help with the defect or help the mother with her health. I encourage people that knowledge is power, and to visit with their physician.”

This post is not intended to diagnose or treat any medical condition. Please seek medical advice from your physician for any related medical condition. If you are in need of a primary care doctor, click here to find one in the Covenant Health network.

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