How to Avoid Birth Defects During Pregnancy

What is a Birth Defect ?

A birth defect is a condition that is present at the time of birth. While some birth defects are readily apparent, such as clubfoot or extra digits, others may require special tests to diagnose, like heart abnormalities or hearing impairments. Some birth defects may not manifest until later in life.

What Causes Birth Defects ?

Birth defects can result from various factors. Some are linked to inherited genes passed from parents to children, while others arise due to chromosomal abnormalities. A subset of birth defects is attributed to prenatal exposure to specific medications, chemicals, or infections. However, the exact causes remain unknown for many birth defects.

How to Avoid Birth Defects during Pregnancy ?

While preventing most birth defects remains challenging due to their elusive causes, you can take certain proactive measures to potentially lower the risk of specific birth defects:

1. Preconception Health Check: Visit your doctor before attempting to conceive. This allows you to assess your overall health and discuss any factors that might increase the risk of birth defects.
2. Prenatal Vitamins: Begin taking a daily multivitamin before and during pregnancy to ensure you receive essential nutrients crucial for fetal development.
3. Infection Prevention: Take steps to prevent infections, as some can lead to birth defects. Practice good hygiene, avoid contact with individuals who have contagious illnesses, and stay up to date with vaccinations.
4. Healthy Weight Maintenance: Maintain a healthy body weight before pregnancy, as obesity can contribute to birth defects. Consult with your healthcare provider for guidance on achieving and maintaining a healthy weight.
5. Medication Use: Always consult with a healthcare professional before using any medications during pregnancy, as certain drugs can pose risks to the developing fetus.
6. Assess Risk Factors: Understand your family’s medical history and genetic predispositions that may increase the likelihood of birth defects. This knowledge can guide your prenatal care.
7. Manage Preexisting Conditions: If you have underlying medical conditions, such as diabetes or epilepsy, ensure they are well-managed before and during pregnancy to minimize potential risks to the baby.
8. Avoid Harmful Substances: Steer clear of alcohol consumption, smoking  and illegal drug use during pregnancy, as these substances can harm the developing fetus.
9. Environmental Awareness: Be cautious of potential environmental hazards and avoid exposure to known harmful agents, such as certain chemicals or pollutants.

Importance of Preconception Care

Scheduling a healthcare visit before becoming pregnant is a prudent step. During this visit, you can receive guidance on diet, exercise, altering medications for medical conditions to safer options and lifestyle choices that promote a healthy pregnancy. Additionally, you and your healthcare provider can identify and address any specific risk factors that might affect your pregnancy outcome. This proactive approach to preconception care helps ensure a smoother and healthier pregnancy journey. (For more information, see also: “How to Plan and Prepare for a Healthy Pregnancy“)

What Factors Increase the Risk of Birth Defects?

Several factors can heighten the risk of having a baby with a birth defect. These include:

• Advanced Maternal Age: Older mothers may face an increased risk.
• Previous Birth Defect: If you’ve had a child with a birth defect before, the risk may be higher in subsequent pregnancies.
• Family or Personal History: A family history of birth defects or your own history of being born with one may elevate the risk.
• Underlying Medical Conditions: Conditions like diabetes or obesity can be associated with a higher likelihood of birth defects.
• Medication Use: Using certain medications around the time of conception or during pregnancy can pose risks.
• Recreational Drug and Alcohol Use: The consumption of recreational drugs or alcohol during pregnancy can increase the risk of birth defects.

Managing Your Risk Factors: If you possess any of these risk factors, your gynecologist may recommend specific tests or precautions to help mitigate these risks. For instance, if you have a personal or family history of birth defects, genetic counseling and testing may be advisable.

Medication Use During Pregnancy

Informing Healthcare Providers: It’s crucial to inform all healthcare providers, including those not related to pregnancy, about your pregnancy status or plans. This includes doctors, mental health professionals, and even your dentist. Avoid accidental or planned exposure to radiations.

Over-the-Counter Medications: Always consult your healthcare professional before taking over-the-counter drugs, such as pain relievers, laxatives, cold or allergy remedies, vitamins, herbal products, or skin treatments during pregnancy.

Importance of Prenatal Vitamins

Essential Nutrients: Prenatal vitamin supplements provide the essential vitamins and minerals needed during pregnancy, such as vitamins A, C, and D, folic acid, and iron.

Preventing Neural Tube Defects: Taking 400 micrograms of folic acid daily, starting at least one month before pregnancy and continuing during pregnancy, can help prevent major birth defects of the baby’s brain and spine, known as neural tube defects.

Folic Acid Content: Most prenatal and “women’s formula” multivitamin supplements contain 400–800 micrograms of folic acid.

The Impact of Obesity on Pregnancy

Increased Risk: Women with obesity (defined as a body mass index , BMI of 30 or greater) at the start of pregnancy face a higher risk of certain birth defects compared to those with a normal weight.

Common Birth Defects: Birth defects associated with obesity often include neural tube defects, heart abnormalities, and cleft palate.

Prevention: Achieving a normal weight before conception is the most effective way to mitigate the potential risks associated with obesity during pregnancy. (You can determine your BMI using a “BMI Calculator“)

Managing Medical Conditions Before Pregnancy

Increased Risk: Certain medical conditions and their drug treatments, such as diabetes mellitus, high blood pressure, and seizure disorders, can elevate the risk of specific birth defects.

Preconception Planning: If you have a medical condition, consult your healthcare professional to discuss necessary adjustments in your diet, medication, or other aspects of your health to ensure the condition is well-managed before attempting pregnancy.

Abstaining from Alcohol During Pregnancy

Leading Cause of Birth Defects: Alcohol consumption during pregnancy is a major contributor to birth defects, collectively known as “fetal alcohol spectrum disorders.” These disorders can result in physical, behavioral, and learning disabilities that can last a lifetime.

Fetal Alcohol Syndrome: One of the most severe outcomes is fetal alcohol syndrome.

Prevention: The key to preventing alcohol-related birth defects is abstaining from all alcohol during pregnancy. It’s a step that can ensure a healthy start for your baby and is entirely within your control.

Managing Infections During Pregnancy

Understanding Infections: Some infections can pose significant risks during pregnancy, potentially leading to birth defects and other complications for both you and your baby. These infections include:

1. Rubella (German Measles): Rubella is a viral infection known for causing a mild rash and low fever. However, contracting rubella during pregnancy can lead to serious consequences, including miscarriage, as well as hearing loss, intellectual disability, heart defects, and blindness in the newborn. While there is a vaccine for rubella, it’s not recommended for pregnant women. If you haven’t had the disease or been vaccinated, it’s advisable to get vaccinated against rubella at least one to three  months before conceiving.
2. Toxoplasmosis: This disease is caused by a parasite found in soil. Infection can occur through consuming raw or undercooked meat, unwashed vegetables, or contact with animal feces, particularly from outdoor cats. First-time infection during pregnancy can result in birth defects, including hearing loss, vision problems, and intellectual disability. To reduce the risk, ensure that meat is thoroughly cooked, wear gloves when gardening or handling unwashed produce, and if you have an outdoor cat with a litter box, ask someone else to handle it. If you must do it yourself, use gloves and wash your hands thoroughly afterward.
3. Sexually Transmitted Infections (STIs): STIs can lead to severe birth defects. It’s essential to seek treatment for any STI, preferably before becoming pregnant, to prevent or minimize harm to the fetus.
4. Cytomegalovirus (CMV): CMV is a common viral infection, typically causing no significant issues. However, a first-time infection during pregnancy can lead to intellectual disability, hearing loss, and vision problems in the baby. CMV can spread through contact with an infected child’s bodily fluids, such as urine. Pregnant women, particularly those working with young children, like daycare or healthcare workers, should take preventive measures, including wearing gloves during diaper changes and practicing frequent handwashing.

Precautions to Minimize Birth Defect Risks

Regardless of specific infections, there are several precautions recommended for all pregnant women:

1. Mercury Exposure: Avoid consuming shark, swordfish, king mackerel, or tilefish, as they may contain high levels of mercury. Limit your consumption of white (albacore) tuna to 6 ounces per week. While it’s not necessary to eliminate all fish from your diet, fish and shellfish can provide essential nutrients during pregnancy. Aim to consume 8–12 ounces of low-mercury fish and shellfish weekly.
2. Lead Exposure: Be cautious about exposure to lead, which can be found in old paint, construction materials, alternative medicines, and products from foreign countries like jewelry and pottery.
3. Vitamin A Intake: Avoid excessive vitamin A intake, as very high levels have been associated with severe birth defects. Limit your daily vitamin A consumption to no more than 10,000 international units.

These precautions can help safeguard both your health and the well-being of your baby during pregnancy.

Author

Dr Sobia Mohyuddin

MCPS, FCPS, MRCOG, Consultant Obstetrics & Gynaecology

Doctor Sobia Mohyuddin is a highly skilled and experienced Obstetrician and Gynecologist, with 25 years of training and experience in renowned, large institutions. She holds the position of Associate Professor and Fellow at the College of Physicians and Surgeons Pakistan. She is also a member of the Royal College of Obstetricians and Gynecologists (UK).