5 things you can do to minimize birth defects
7/21/2022 by Matthew Meunier, M.D.
Birth defects happen in about 3%–4% of pregnancies. Many defects result from causes that can't be avoided, such as inherited disorders or chromosomal abnormalities. However, patients who are planning to have a baby, or who are already pregnant, can take steps to minimize the chance of having a baby with a birth defect.
Take a multivitamin with folic acid before and during pregnancy
Taking a daily multivitamin with folic acid for at least a month before getting pregnant is something simple all women can do. And it's a step that can have a dramatic impact on preventing serious abnormalities of the brain and spine called neural tube defects. While a multivitamin has a number of good vitamins and minerals that can help with fetus development, folic acid is the critically needed vitamin.
The recommended minimum daily intake of folic acid is 400 micrograms, which is found in most women's multivitamins. Some pregnancies are at higher risk of neural tube defects due to medications and family history. If this is the case for you, your primary care clinician may recommend taking a higher dose of folic acid.
Make sure all vaccinations are up to date
Vaccinations can protect you and your baby during pregnancy. Discuss with your primary care clinician which vaccinations you're due for, ideally before you become pregnant.
The measles, mumps and rubella vaccination, commonly referred to as MMR, and varicella, or chickenpox, vaccines, protect against serious viruses that can lead to birth defects in pregnancy. These are both live vaccines, so you need to get them at least one month before you become pregnant. Once you're pregnant, your primary care clinician will check to see that you have protection, or immunity, from these viruses. If you don't, you'll need to get vaccinated after delivery.
It's strongly recommended that pregnant patients be vaccinated for COVID-19. Becoming infected with COVID-19 during pregnancy is associated with an increased risk of preterm birth, increased risk of serious illness in patients who are pregnant and possibly stillbirth. There is no evidence that getting vaccinated for COVID-19 poses a risk in pregnancy or while breastfeeding.
Getting vaccinated for influenza during pregnancy is safe and highly recommended. Pregnant women have an increased chance of serious illness if they develop the flu, which can put both mother and baby at serious risk. Don't delay. Get your flu shot today.
Pertussis, or whooping cough, outbreaks are increasing across the country. Thankfully, a vaccine is available to help. The tetanus diphtheria and acellular pertussis, or Tdap, vaccine, protects against pertussis. It is highly recommended in every pregnancy after 27 weeks gestation.
Commit to a healthy lifestyle before you get pregnant
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. Obese women have a greater chance 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, have been associated with birth defects.
These include:
- Recreational substances and illegal drugs.
- Medications for acute or chronic diseases.
- Various infections.
Recreational substances, such as alcohol; 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 also they can contribute to newborns who are small or born early. You should stop using these substances before getting pregnant.
Various medications can be used safely during pregnancy, while other should be limited or avoided. Many over-the-counter cold, flu or pain medications, and many prescriptions, have been associated with birth defects. So it's important to review your medical list with your primary care clinician before getting pregnant. Contact your health care team before starting or stopping any medication while pregnant.
A number of infections have been linked to birth defects, so you should avoid exposure to them, whenever possible.
These include:
- Toxoplasmosis
This infection is caused by a parasite found in soil and animal feces. Wear gloves when working in the garden, thoroughly wash vegetables, don't eat undercooked meats and avoid contact with used cat litter. - Cytomegalovirus
People infected with this virus often don't know they have it. However, it can cause birth defects in women who are pregnant. It's found in the urine and other bodily fluids of young children. Pregnant women who have or work with young children should wear gloves when changing diapers and wash their hands frequently. - Sexually transmitted infections
Avoid unprotected sexual contact with infected people.
See your primary care provider before getting pregnant
A prepregnancy or preconception visit with your primary care clinician can help ensure that all your individual risk factors are minimized before you get pregnant. Your primary care clinician can review your medical and family histories to identify potential risk factors and check that you're 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.
Taking these five steps can help ensure you have a healthy baby.
Matthew Meunier, M.D., is a family medicine physician with Women's Health fellowship training in the Department of Family Medicine. He is the program director of the Family Medicine Residency Program in Rochester and Kasson.