Prevention of Congenital Anomalies

Running head: Prevention of Congenital Anomalies 1

Prevention of Congenital Anomalies

Lisa J Murphy

Cochise College

Prevention of Congenital Anomalies 2

Abstract

"We are what we eat." People in today's society do not understand the pertinence of eating healthy and maintaining a healthy body. It has been proven time and time again that a poor diet leads to poor health. So why is it that a fetus in utero can have poor health when it is not consuming its own sustenance yet? I am sure we all know that the answer is the mother.

Prevention of Congenital Anomalies 3

Prevention of Congenital Anomalies

"We are what we eat." People in today's society do not understand the pertinence of eating healthy and maintaining a healthy body. It has been proven time and time again that a poor diet leads to poor health. So why is it that a fetus in utero can have poor health when it is not consuming its own sustenance yet? I am sure we all know that the answer is the mother. Anything and everything that is ingested by the mother passes to baby. According to Community Genetics (2002) , "Two to six percent of the newborn babies worldwide, i.e. 3-9 million infants a year, suffer from major congenital anomalies and genetic diseases." (p. 86) . Many of this anomalies are preventable or at least within the mother's hands to manipulate and control. The best way to prevent some common anomalies is to refrain from smoking and consuming alcohol, to maintain a healthy diet, include folic acid in one's diet. Further problems can arise from those who are obese and may have difficulty maintaining stress levels but there are still ways to monitor and aid in the success of pregnancies for those cases.

One of the crucial contributors to the prevention of congenital anomalies is folic acid. Folic acid is typically found in a multi vitamin for daily consumption. For pregnant women, folic acid is given in a larger than normal amount to help prevent neural tube defects and other congenital anomalies. There have been many studies conducted providing evidence to support this supplement. One in particular is: Prevention of congenital abnormalities by periconceptional multivitamin supplementation. (BMJ, 1993) This study showed evidence of the importance of folic acid in pregnancy for it preventative measures of congenital anomalies. The results

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presented below show the decrease in anomalies when pregnant subjects were given a supplement containing a small amount of folic acid versus those who were not. Recent evidence shows that taking a supplement containing folic acid, and a B-vitamin starting a month before conception and during pregnancy can seriously reduce the risk of having a child born with a birth defect, especially one of the brain or spine.

BMJ-British Medical Journal's (1993) study found the following: OBJECTIVE--To study the effect of periconceptional multivitamin supplementation on neural tube defects and other congenital abnormality entities. DESIGN--Randomised controlled trial of supplementation with multivitamins and trace elements. SETTING--Hungarian family planning program. SUBJECTS--4156 pregnancies with known outcome and 3713 infants evaluated in the eighth month of life. INTERVENTIONS--A single tablet of a multivitamin including 0.8 mg of folic acid or trace elements supplement daily for at least one month before conception and at least two months after conception. MAIN OUTCOME MEASURES--Number of major and mild congenital abnormalities. RESULTS--The rate of all major congenital abnormalities was significantly lower in the group given vitamins than in the group given trace elements and this difference cannot be explained totally by the significant reduction of neural tube defects. The rate of major congenital abnormalities other than neural tube defects and genetic syndromes was 9.0/1000 in pregnancies with known outcome in the vitamin group and 16.6/1000 in the trace element group; relative risk 1.85 (95% confidence interval 1.02 to 3.38); difference, 7.6/1000. The rate of all major congenital abnormalities other than neural tube defects and genetic syndromes diagnosed up to the eighth month of life was 14.7/1000 informative pregnancies in the vitamin group and 28.3/1000 in the trace element group; relative risk 1.95 (1.23 to 3.09);

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difference, 13.6/1000. The rate of some congenital abnormalities was lower in the vitamin group than in the trace element group but the differences for each group of abnormalities were not significant. CONCLUSIONS--Periconceptional multivitamin supplementation can reduce not only the rate of neural tube defects but also the rate of other major non-genetic syndromatic congenital abnormalities. (p. 1645-1648.)

Smoking is also a factor. Women who smoke before and during pregnancy are at a higher risk for having a child with a birth defect. Cleft palate and cleft lip are among the most common of birth defects. A woman who smokes or did smoke has a higher risk of having her child born with one or both of these defects. Smoking contributes to low birth weight and premature delivery. Smoking increases the risk of SIDS (sudden infant death syndrome) for the baby. It also has an effect on placenta. From smoking, the risk is increased for the placenta to separate too early from the womb and cause severe hemorrhage, which is very serious for mother and baby. The hemorrhaging can be as serious as causing fatalities to both mother and baby.

Obesity is another serious issue. Obese women are at a higher risk of having diabetes and or gestational diabetes, both of which are serious. In the first trimester and at the time of conception, maternal hyperglycemia can cause diabetic embryopathy resulting in major birth defects and spontaneous abortions. This primarily occurs in pregnancies with pregestational