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HEALTH: Millions of Birth Defects Preventable

Sanjay Suri

LONDON, Jan 30 2006 (IPS) - A little care could save millions of children born with birth defects every year, a new report says.

Every year an estimated eight million children – about six percent of total births worldwide – are born with a serious birth defect of genetic or partially genetic origin, according to a new report from the U.S.- based research group, the March of Dimes.

”We’re talking of six to seven percent of the 130 million or so children born every year being affected by a serious birth defect that will either cause a child to die, or if a child doesn’t die, it will place the child at serious risk of disability,” Dr Arnold Christianson from the National Health Laboratory Service in Johannesburg, a co-author of the report told IPS.

Additionally, hundreds of thousands more are born with serious birth defects of post-conception origin due to maternal exposure to environmental agents, such as alcohol, rubella, and syphilis, says the ‘Global Report on Birth Defects: The Hidden Toll of Dying and Disabled Children’.

The report reveals that at least 3.3 million children less than five years of age die annually because of serious birth defects, defined as any serious abnormality of structure or function. An estimated 3.2 million of those who survive may be mentally and physically disabled for life.

Birth defects are a global problem, but their impact is particularly severe in middle and low income countries where more than 94 percent of births with serious defects and 95 percent of the deaths of these children occur, the report says. Both high prevalence rates and larger numbers of births contribute to the differences between low and middle income countries and those with higher incomes.

”But about 70 percent of birth defects can either be prevented, or with treatment you can significantly reduce the chance of a child to die or improve the disability,” Dr Christianson said.

While governments do what they can, there are some things mothers or would-be mothers can do straightaway, Christianson said.

”The first thing to do is to plan your pregnancy,” he said. ”And when you plan your pregnancy, eat the appropriate foods vitamins and folic acid and ensure that you have been immunised against rebella. It’s very different not to drink alcohol around the time of conception or during your pregnancy. These will help you ensure you can conceive and have a normal baby.”

In South Africa 14,000 birth defects are caused every year simply by mothers taking alcohol, he said.

Other simple measures like fortifying food with folic acid in low and middle income countries can give a lot of mothers the essential nutrients they need, Christianson said.

The most common birth defects are congenital heart defects, neural tube defects, the haemoglobin disorders thalassemia and sickle cell disease, Down syndrome and glucose-6-phosphate dehydrogenase deficiency (G6PD).

Thalassemia has been known to follow from malaria. ”Thalassemia or sickle cell is common in areas where malaria was or is common,” Dr Bernadette Modell, from the Royal Free and University College Medical School in London, and co-author of the report told IPS. ”When malaria is controlled, malaria goes away, but of course the genetic conditions do not go.”

In India, she said, thalassemia is an indicator that malaria used to be there, though malaria itself is still prevalent in some areas. In addition to poverty and the many health problems that can accompany it, the report points to major demographic reasons for the higher rates of birth defects in poorer countries, including more women of advanced age having children and a greater frequency of consanguineous (blood relative) marriages.

The report recommends several steps for low-income countries. These include:

– Educate the community, health professionals and workers, policy makers, the media and other stakeholders about the toll taken by birth defects and opportunities for effective prevention, treatment and care.

– Ensure a healthy, balanced diet during a woman’s reproductive years.

– Control infections in pregnant women.

– Train physicians, nurses, allied health professionals and workers in the recognition and care of children with birth defects.

– Establish national capacity for birth defects surveillance and monitoring.

The report is accompanied by a database that details the prevalence rates and the numbers of affected births in 193 countries.