5 things you can do to minimize birth defects

1/9/2020 by Katherine (Katie) Schupack, DO

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Birth defects happen in about 3 to 4% of pregnancies. Many defects result from causes that can't be avoided, such as inherited disorders or chromosomal abnormalities. However, there are steps women who are planning to have a baby or who are already pregnant can take 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 a very simple thing all women can do. And it's one 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 risks of neural tube defects due to medications and family history. If this is the case for you, your primary care provider may recommend taking a higher dose of folic acid. 

Make sure all vaccines are up to date

Vaccines can protect both you and your baby during pregnancy. Discuss with your primary care provider which vaccines you're due for, ideally before you become pregnant. The measles-mumps-rubella (MMR) and varicella 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 provider will check to see that you have protection (immunity) from these viruses. If you don't, you'll need to get the vaccines after delivery. 

Getting the flu (influenza) shot during pregnancy is safe and very 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 (whooping cough) outbreaks are increasing across the country, but thankfully we have a vaccine to help. The Tdap vaccine protects against pertussis and is highly recommended in each pregnancy after 27 weeks gestation. When this vaccine is given in the third trimester, it provides protection to the infant after birth. This is critical, since infants aren't given their first pertussis vaccine until they're two months old. The immunity effect from their mother will protect them in the first months of life. 

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. In fact, 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 they also can contribute to newborns that are small or born early. Use of these substances should be stopped before you get pregnant. 

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

  • Zika virus: Zika is transmitted by mosquitoes in tropical areas of the world. Avoid travel to locations with a high rate of Zika before and during pregnancy. 
  • 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. 
  • Sexually transmitted infections: Avoid unprotected sexual contact with infected individuals. 
  • Cytomegalovirus: People 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 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'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. 

Dr. Katherine Schupack is a family medicine physician in Primary Care in Rochester's Department of Family Medicine. She is core faculty in the Mayo Family Medicine Residency Program. Her areas of interest are residency medical education, physician wellness, women's health and lifestyle and geriatric medicine.