Strategies for preventing birth defects

Conventional wisdom is that good antenatal care during pregnancy results in a healthy baby. Though this is correct to some extent, there are steps that can be taken months prior to conceiving that can decrease the risk of having a baby with birth defects.

Organogenesis (organ formation) occurs early in the first trimester of pregnancy. By the time a woman realizes that she is pregnant and seeks prenatal care, organ abnormalities (if going to occur), have already occurred. The incidence of congenital abnormalities can be decreased by planning the pregnancy. Almost half of pregnancies in the U.S. are unplanned.

Birth defects are the result of genetic and environmental factors. Of course, genetic factors cannot be controlled, but all environmental or non-genetic factors are modifiable. By controlling these, a woman can substantially increase her chance of having a healthy baby. Below are some strategies that you can use to prevent birth defects as you consider starting or adding to your family. 

Maintain a healthy weight

Obesity increases the risk of having a baby with several different types of heart defects. The risk is typically associated with BMI (body mass index) greater than 29 (moderate obesity), although mild obesity has also been shown to increase the risk (BMI 25 to 29). 

Underweight or BMI less than 18 is also a risk factor for having an unhealthy baby. 

Keep diabetes (Type 1 & Type 2) under control

Uncontrolled diabetes several months prior to pregnancy is a major cause of birth defects, especially serious birth heart abnormalities. Studies have very convincingly proved that stringent control of blood sugar a few months prior to conceiving could eliminate teratogenic (causing developmental malformations) effect of diabetes.

Consume enough folic acid and other vitamins

Epidemiologic studies have suggested taking folic acid and multivitamins several months prior to conceiving decreases the incidence of neural and other birth defects.

Eating healthy and practicing a good life style a year prior to pregnancy will increase chances of having a healthy baby. Taking prenatal vitamins several months before conception is typically recommended.

Avoid alcohol when you start trying to get pregnant

Alcohol is a proven teratogen (an agent or factor that causes malformation of an embryo). It is known to cause structural and neurodevelopmental abnormalities.

The Centers for Disease Control and Prevention (CDC) recommends avoiding alcohol several months prior and during the pregnancy

Avoid smoking cigarettes

Smoking is an established risk factor for having low birth weight and premature baby. It also increases some risk for congenital malformations. It should be avoided several months prior and during the pregnancy.

Avoid marijuana and other drugs

Use of marijuana or other drugs during pregnancy can result in a baby who is born preterm, of low birth weight, or has other health problems, like birth defects.

Consult your doctor before taking medicine

General principle is if one can avoid taking any medicine a few months prior and during the first trimester, it should be done. Of course this should be done in consultation with your doctor. Any medicine even over the counter medicines should be taken after approval from your doctor.

Known Teratogens (an agent or factor that causes malformation of an embryo):

  • Retinoic acid/Acutane
  • High dose vitamin A
  • Lithium
  • Ace inhibitors
  • Anticonvulsant medications
  • Antidepressants and SSRIs
  • Trimethoprim and sulfa drugs
  • Corticosteroids 
  • Infections (febrile illness while trying to conceive)

Advanced maternal age

Age at the time of conception is another aspect that can affect the health of your baby. There are many women who are now having babies later in life, there is a slight increased risk for having a baby with a chromosomal abnormality after the age of 35 years and that risk increases further after the age of 40 years. 

Most of the other risks associated with having a baby later in life can be decreased by taking all the steps that have been mentioned prior to conception.

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