Report: 8 million born with birth defects yearly

Women's health
Every mother-to-be has about a 5 percent chance of having a baby with a serious birth defect, the so-called “background rate,” explained Dr. Arnold Christianson of South Africa’s University of Witwatersrand, who co-wrote the report.

That risk can rise or fall, depending on a host of circumstances: Does she take folic acid, a nutritional supplement that fights neural tube defects? Is she vaccinated against rubella? Does she have uncontrolled diabetes or other pregnancy-harming illnesses? Is she well-nourished? Are her pregnancies spaced far enough apart?

“If mom can be as fit and well as possible at the time of conception, it reduces the risk of a birth defect,” Christianson said.

Among the report’s recommendations:

• Improved health care for all women, with special emphasis on pregnancy nutrition.
• Improved family planning and birth-defect education. In Johannesburg, surveys show less than 40 percent of African women know what Down syndrome is, much less that their risk rises with pregnancies after age 35, Christianson said.
• Proper care of affected babies. In South America, for example, 55 percent of babies with Down syndrome die before their first birthday. Median U.S. survival is age 51, up from age 3 in the 1960s thanks to improved care.

“Care is an absolute,” Howson said. “Prevention is the ideal.”

And prevention can be cheap: Fortifying grain with folic acid costs about a penny per year per person, Cordero said.

In 2000, Chile added enough folic acid to wheat flour to cause a 40 percent reduction in neural tube defects. The U.S., with lower fortification levels, saw a one-third drop.

Even gene tests can be relatively inexpensive. The report cites Iran which, faced with skyrocketing costs for thalassemia care, in 1997 began giving couples a $5 gene test prior to marriage. Some separate if both carry the disease-causing gene, but they also can opt for fetal testing if they choose to conceive. By 2001, more than 2.7 million prospective couples had been screened, 10,298 at-risk couples identified and counseled — and thalassemia births had fallen to 30 percent of the expected rate.

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