January is National Birth Defects Prevention Month. Pregnancy can be a particularly stressful time for prospective parents, and as their physician you should be getting them as prepared as they can be for a healthy birth.

Your patients may not be aware of a number of risk factors for neonatal birth defects, some because they’re such commonplace occurrences and others because they are simply not generally considered.

  1. Stressors

Stress is a risk factor for numerous difficulties during pregnancy, including birth defects. A study published in BMC Pregnancy and Childbirth in August 2020 found that certain stressors may correlate with an increased risk of certain birth defects.¹ Pregnant women who reported that they or someone they knew were victims of abuse, violence, or a crime were found to be at increased risk for late preterm birth or delivering an infant of low birth weight. A risk for early preterm birth or delivering an infant of low birth weight was suggested for women who reported experiencing stress from relationship difficulties. The researchers also did not find strong evidence that positive social support could counter the risk.


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  1. Lack of folic acid

A 2020 study published in The Pan African Medical Journal examined associated factors with birth defects among newborns in countries in sub-Saharan Africa.² One factor the researchers found that correlated with birth defects was a lack of folic acid supplementation. The researchers found that infants born to mothers who did not receive folic acid supplementation were 3.92 times more likely to have birth defects than those born to mothers who received supplementation. The US Centers for Disease Control and Prevention (CDC) recommends 400 micrograms of folic acid daily in addition to folate from food to help prevent neural tube defects.³

  1. Preventable maternal illness

The researchers also analyzed maternal illness as a factor contributing to birth defects and found that illness during pregnancy was associated with a higher risk in birth defects. Stress the importance of healthy lifestyles to your pregnant patients. In addition to aforementioned vitamin supplementation, patients should undergo recommended vaccinations (the flu shot in particular), maintain a nutritious diet, and take necessary steps to avoid infections.

  1. High temperatures and pollution

Environmental factors may also increase birth defect risk in ways your patients don’t anticipate. A 2020 study in The International Journal of Environmental Research and Public Health assessed the seasons of conception for newborns born in Texas from 1999 to 2015 to see if there were any associations between seasons and birth defects.⁴ The researchers found a potential correlation between birth defects and newborns conceived in spring and summer, in part due to how intense the heat can be in Texas. In addition to the heat exposure, such high temperatures can also affect air quality and the concentration of pollutants and ozone. Exposure to ozone has been associated with an increased risk of both preterm birth and low birth weight.

References

  1. Weber KA, Carmichael SL, Yang W, Tinker SC, Shaw GM; National Birth Defects Prevention Study. Periconceptional stressors and social support and risk for adverse birth outcomes. BMC Pregnancy Childbirth. 2020;20(1):487. doi:10.1186/s12884-020-03182-6
  2. Adane F, Afework M, Seyoum G, Gebrie A. Prevalence and associated factors of birth defects among newborns in sub-Saharan African countries: a systematic review and meta-analysis. Pan Afr Med J. 2020;36:19. doi:10.11604/pamj.2020.36.19.19411
  3. Recommendations: women & folic acid. Centers for Disease Control and Prevention website. https://www.cdc.gov/ncbddd/folicacid/recommendations.html. Reviewed August 13, 2019. Accessed January 25, 2021.
  4. Benavides E, Lupo PJ, Langlois PH, Schraw JM. A comprehensive assessment of the associations between season of conception and birth defects, Texas, 1999-2015. Int J Environ Res Public Health. 2020;17(19):7120. doi:10.3390/ijerph17197120