Employee & Community Health

4 things you can do to minimize birth defects

1/5/2017 by Dr. Matthew Meunier

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Birth defects happen in about three to four percent of pregnancies. Some can be identified easily at birth, such as an extra finger or toe, while others, such as heart or joint abnormalities, are found with the help of thorough medical exams and special testing. 

When birth defects are discovered, a number of tests can be used to determine the cause, but finding one isn't always possible. Many defects can result from causes that can't be avoided, such as inherited disorders or chromosomal abnormalities. However, there are many things women who are planning to have a baby and those who are pregnant already can do to minimize the chance of having a baby with a birth defect. 

Take a multivitamin before and during pregnancy. Taking a daily multivitamin for at least a month before getting pregnant is a very simple thing women can do. And it's one that can have a dramatic impact on preventing serious abnormalities of the brain and spine. While a multivitamin has a number of good vitamins and minerals that can help with fetus development, folic acid is critically needed vitamin. The recommended minimum daily intake of folic acid is 400 micrograms, which is found in most women's multivitamins. Most prenatal vitamins contain 800 micrograms. 

Stay healthy before you get pregnant. In addition to taking a multivitamin, doing all you can to stay healthy before pregnancy can help ensure you have a healthy baby. A well-rounded, healthy diet and regular exercise can prevent birth defects, as well as increase your chances of becoming pregnant. Being overweight can contribute to a number of illnesses, such as diabetes, elevated blood pressure and heart disease, all of which increase the risk of birth defects. In fact, obese women have an increased risk of giving birth to babies with spine, heart and cleft palate defects, even if they don't have any other medical conditions. 

Avoid risky exposures. Exposures to certain substances, called teratogens, has been associated with birth defects. These include:

  • Recreational substances and illegal drugs
  • Medications for acute or chronic illnesses
  • Various infections

Recreational substances - such as alcohol and tobacco and illegal drugs, including marijuana, cocaine, heroin and methamphetamines - negatively affect pregnancies in a number of ways. Not only do they increase the risk of birth defects, but they also can contribute to newborns who are small or premature. Use of these substances should be limited or stopped before you get pregnant. 

A variety of medications can be used safely during pregnancy, while others should be limited or avoided. These include some over-the-counter cold, flu or pain medications and many prescription medications, which have been associated with birth defects. That's why it's important to review your medication list with your primary care provider before getting pregnant. 

A number of infections have been linked to birth defects, and you should avoid exposure to them whenever possible. These infections include: 

  • Zika virus: Zika is transmitted by mosquitoes in topical areas of the world. Avoid travel to locations with a high rate of Zika before and during pregnancy. 
  • Rubella and varicella: These two infections can be prevented with immunizations. Ensure your immunizations are up to date before you get pregnant in order to protect yourself and your baby. 
  • Toxoplasmosis: This infection is caused by a parasite found in soil and animal feces (poop). Wear gloves when working in the garden, thoroughly wash vegetables, don't eat undercooked meats and avoid contact with used cat litter. 
  • Sexually transmitted infections: Avoid unprotected sexual contact with infected individuals. 
  • Cytomegalovirus: People who are infected with this virus often don't know they have it. However, it can cause birth defects in pregnant women. It's found in the urine and other body fluids of young children. Pregnant women who have or work with young children should wear gloves when changing diapers, and wash their hands frequently. 

See your primary care provider before getting pregnant. A pre-pregnancy or pre-conception visit with your primary care provider can help ensure that all of your individual risk factors are minimized before you get pregnant. Your provider can review your medical and family histories to identify potential risk factors and check that you are only on medications that are safe during pregnancy. Occasionally, women have blood tests at this visit to screen for infections that could affect their pregnancy. 

Dr. Matthew Meunier is a family physician with Women's Health fellowship training in Employee and Community Health's (ECH) Department of Family Medicine. He is the Chief of Family Medicine Obstetrics and Newborn Services.