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Published on December 18, 2013

Crozer-Keystone Physicians and Midwives Deliver Guidance on Preventing Birth Defects

In Brief

  • Birth defects are a leading cause of death among U.S. infants.
  • Not all birth defects can be prevented, but a woman can increase the chances of giving birth to a healthy baby by managing health conditions and adopting healthy behaviors even before she becomes pregnant.
  • The Crozer-Keystone Center for Perinatal Medicine offers a full-spectrum of perinatal services to pregnant women and their families at Crozer-Chester Medical Center and Delaware County Memorial Hospital.

Every five minutes, a baby is born with a major birth defect in the United States, according to the Centers for Disease Control (CDC). Birth defects are a leading cause of death among U.S. infants, accounting for about 20 percent of mortality in the first year of life. Babies born with birth defects also have a greater risk of illness and long-term disability than babies without birth defects. January is National Birth Defects Prevention Month, a time to raise awareness about the frequency of birth defects and steps that can be taken to prevent them.

“Although not all birth defects can be prevented, a woman can increase the chances of giving birth to a healthy baby by managing health

conditions and adopting healthy behaviors even before she becomes pregnant,” says Hugh M. Ehrenberg, M.D., director of Maternal Fetal Medicine at Crozer-Chester Medical Center and Delaware County Memorial Hospital (DCMH). “This is important because many birth defects happen very early during pregnancy, sometimes before a woman even knows she is pregnant.”

Here are some steps a woman can take to prepare for and maintain a healthy pregnancy, according to Crozer-Keystone Health System obstetricians/gynecologists and certified nurse midwives.

Take 400 micrograms (mcg) of folic acid every day. If a woman has enough folic acid in her body before conception and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine (anencephaly and spina bifida), according to the CDC.

“Studies have shown that a folic acid deficiency can lead to birth defects, like spina bifida,” says Thomas Bader, M.D., chairman of the Department of Obstetrics and Gynecology at Crozer-Chester Medical Center. Taking a folic acid supplement reduces the incidence of this birth defect and is known to be an essential component of many important metabolic pathways. It also seems to play a role in cell division and tissue growth.”

Avoid alcohol, tobacco and illegal (“street”) drugs.  Substances in a pregnant woman’s blood pass through the placenta to her fetus through the umbilical cord. Drinking alcohol during pregnancy can cause a baby to be born with a fetal alcohol spectrum disorder (FASD).

Smoking during pregnancy increases the risks of premature birth, certain birth defects (cleft lip or cleft palate), and infant death. It is safest to quit smoking before becoming pregnant, but quitting as early as possible in pregnancy can still reduce some health risks, such as low birth weight — and it’s never “too late” to quit.

Use of illegal (“street”) drugs during pregnancy can cause premature birth, low birth weight and birth defects. Avoid “recreational” drug use, and seek professional help for drug and alcohol addictions.

See a health-care professional for regular health screenings, gynecologic exams and perinatal care. A woman should see her family physician, obstetrician/gynecologist or midwife for routine wellness and gynecologic exams — especially when she is of childbearing age.

“Because the fetus is fully formed by 10 weeks of the pregnancy, the major birth defects occur by then,” says Joseph Grover, M.D., chairman of the

Department of Obstetrics and Gynecology at DCMH. “Early consultation prior to getting pregnant, especially if the prospective mom has a health concern, is essential. In addition to the pre-conception tips, I recommend that my patients be up to date on immunizations, like Rubella. Having the right vaccinations at the right time can help keep a woman and her baby healthy.”

In fact, “Because about half of all pregnancies are unplanned, every

woman of childbearing age needs to think about her ‘pre-conceptional health’ and talk about it with her health-care provider at every gynecological check-up,” says Rebecca Choitz, CNM, director of Midwifery Services for Crozer-Keystone.

Talk to a physician or midwife about other vaccinations to prevent infections that may have adverse effects on the mother’s or baby’s health, if not birth defects. “For example, the seasonal flu shot and ‘Tdap’ (tetanus, diphtheria and pertussis) are generally recommended during pregnancy — not only for mom, but also for dad, significant others and other adults who will be handling the newborn,” says Choitz. 

Throughout pregnancy, continue to see a physician or midwife for regular perinatal care. 

Eat a nutritious diet and stay fit to reach and maintain a healthy weight — ideally, before becoming pregnant.  A woman who is significantly overweight before pregnancy — a body mass index (BMI) of 30 or higher; for example, a 5’4”-tall woman weighing 180 pounds — is at a higher risk for complications during pregnancy.

“Obesity not only increases the risk of several serious birth defects for the baby, it also interferes with the sensitivity of ultrasound to detect birth defects,” says Ehrenberg. “We may have to delay an ultrasound exam by two to three weeks to wait for a change in the baby’s position in the mother’s belly that will allow us to obtain a clear image, and delays may affect treatment options.”

Ehrenberg says an overweight mother-to-be should work with her health-care provider to modify her food choices.

Keep diabetes under control. Poor control of diabetes during pregnancy increases the chances for birth defects and other health problems for the baby and serious complications for the mother.

Talk to a health-care provider about taking any medications. Taking certain medications during pregnancy can cause serious birth defects, but the safety of many medications taken by pregnant women has been difficult to determine. Women should talk with a physician or midwife  before starting or stopping any medications, including prescription and over-the-counter medications and dietary or herbal products.

Seek testing for birth defects as recommended. The Crozer-Keystone Center for Perinatal Medicine offers a full-spectrum of perinatal services to pregnant women and their families at Crozer-Chester Medical Center and Delaware County Memorial Hospital. The center offers consultative and prenatal care is available to women at high risk for complications or experiencing a complicated pregnancy.  Services include tests to monitor fetal health, such as non-stress testing and biophysical profile, fetal echocardiogram, and 2D, 3D and “4D” ultrasound. The center has received ultrasound accreditation from the American Institute of Ultrasound in Medicine (AIUM). The center offers tissue-sampling procedures for genetic testing, such as Chorionic Villus Sampling (CVS) and amniocentesis, as well treatments such as fetal blood transfusions. The center also provides genetic counseling, nutrition counseling and management for diabetes in pregnancy. 

Crozer-Keystone’s experienced medical and nursing staff includes obstetricians/gynecologists, family physicians and certified nurse midwives with exceptional knowledge and experience. Each year, they deliver more than 3,700 babies at Crozer-Chester Medical Center and Delaware County Memorial Hospital. Crozer-Keystone’s maternity healthcare providers have offices throughout Delaware County and northern Delaware.

For more information about the Crozer-Keystone Center for Perinatal Medicine, to learn more about Crozer-Keystone’s Maternity Services, or make an appointment with an physician or midwife, call 1-855-CK-BABIES (1-855-252-2243) or visit http://4Ubaby.crozerkeystone.org.

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Pager: 610-541-3130

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