January is National Birth Defects Prevention Month, which marks the nation’s annual reminder to spread awareness and prevention strategies of birth defects and congenital malformations. The National Birth Defects Prevention Network (NBDPN) estimates that a baby is born with birth defect every 4 ½ minutes in the United States and aims to raise awareness of preventative approaches for future parents. The Centers for Disease Control (CDC) translates this incidence of birth defects to 1 in every 33 babies born, or about 120,000 neonates in the US each year.
Birth defects are structural differences that are present at birth that can affect any single or multiple parts of the body. These can range from mild to severe, and the overall prognosis depends mostly on which body part or organ is involved and how severely it is affected.
Although not all birth defects can be prevented, you may be able to increase your chances of having a healthy baby by taking care of yourself both physically and mentally. Discussing your health with your provider is always a solid first step. Reviewing your current medical problems and editing any medications or supplements you are taking can be crucial prior to and during pregnancy. For example, discontinuing use of isotretinoin (a drug used to treat acne and known to cause specific anomalies), adjusting your diabetes medications, and adding certain supplements may be advised.
Drafting a treatment plan prior to pregnancy with your healthcare provider can optimize those 9 months, and the many years to come thereafter. This is especially important for expectant mothers over the age of 34, and those who have a significant family history of congenital malformations. Your doctor may suggest you see a geneticist or genetic counselor prior to, or during your pregnancy. Being up-to-date on vaccinations and your annual flu shot are a few important first steps. While on the topic of injections, it’s important to note that you should discuss your pregnancy or pregnancy planning with your plastic surgeon and avoid any elective injectable or surgical procedures during this time.
As obesity increases the risk of several serious birth defects and other complications during pregnancy, it is important to try to reach a healthy weight prior to conceiving. Strengthening and toning the abdominal wall and back musculature will serve you well over the next few months! In addition to eating healthy, supplementing your diet with folic acid (400 micrograms) every day is paramount. Folic acid is critical as it can help prevent major birth defects of the baby’s brain and spinal cord.
It goes without saying that cigarettes are harmful to your health and well-being, but smoking tobacco can seriously disrupt the placenta and can result in an array of harmful chemicals reaching the baby’s bloodstream. Similarly, despite recent decriminalization, marijuana should not be used during pregnancy, since we know of no safe dosing levels. Avoiding other harmful substances like alcohol and other drugs is equally vital. It is important to remember that there is no recommended safe amount of alcohol intake during pregnancy and exposure can result in a variety of congenital malformations, Fetal Alcohol Syndrome, or even miscarriage. Similarly, the use of opiods can also result in drug withdrawal, premature birth, and neonatal abstinence syndrome.
Although not all birth defects can be prevented, having one or more of these risk factors does not mean you will have a pregnancy affected by a birth defect. Even without these risks, women can have a child born with a birth defect who may need special care or interventions to survive and develop. During Birth Defects Prevention Month, it’s important to keep in mind that early interventions can be critical to improving outcomes for those families affected and it is important to ask your provider about local resources and treatments.
Authored by Dr. Sean Herman, plastic and reconstructive surgeon specializing in cleft and craniofacial surgery at The Institute for Advanced Reconstruction at The Plastic Surgery Center.