What you need to know about birth defects

Every 4 ½ minutes in the US, a baby is born with a birth defect. That means that nearly 120,000 (or 1 in every 33) babies are affected by birth defects each year. They are a leading cause of death in the first year of life, causing one in every five infant deaths and they lead to $2.6 billion per year in hospital costs alone in the United States.

What are birth defects?

Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body and can affect any part of the body (such as the heart, brain, foot, etc). They may affect how the body looks, works, or both.

There are thousands of different birth defects and they can be very mild or very severe. Some do not require any treatment, while others may require surgery or lifelong medical interventions.

What causes birth defects?

We know what causes certain birth defects. For instance, drinking alcohol while you are pregnant can cause your baby to be born with  physical birth defects and mental impairment. And genetic conditions, such as cystic fibrosis or sickle cell disease, are the result of inheriting a mutation (change) in a single gene. However, we do not know what causes the majority of birth defects. In most cases, it is a number of complex factors. The interaction of multiple genes, personal behaviors, and our environment all may all play a role.

Can we prevent birth defects?

Most birth defects cannot be prevented. But there are some things that a woman can do before and during pregnancy to increase her chance of having a healthy baby:

• See your healthcare provider before pregnancy and start prenatal care as soon as you think you’re pregnant.
• Get 400 micrograms (mcg) of folic acid every day. Folic acid reduces the chance of having a baby with a neural tube defect.
• Avoid alcohol, cigarettes, and “street” drugs.
• Talk to your provider about any medications you are taking, including prescription and over-the-counter medications and any dietary or herbal supplements. Talk to your provider before you start or stop taking any type of medications.
• Prevent infections during pregnancy. Wash your hands and make sure your vaccinations are up to date.
• Make sure chronic medical conditions are under control, before pregnancy. Some conditions, like diabetes and obesity, may increase the risk for birth defects.
• Learn about your family health history.

Have questions? Email us at AskUs@marchofdimes.org.

Tags: alcohol during pregnancy, birth defects, diabetes, family health history, folic acid, genetic condition, medications during pregnancy, National Birth Defects Prevention Month, obesity, preconception care, prenatal care, smoking during pregnancy, vaccinations

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Antidepressant use and the risk of ASD

A new study suggests that the use of antidepressants during pregnancy, specifically in the second and third trimesters, may increase the risk of autism spectrum disorder (ASD) in children.

While these findings help to add to our understanding of autism, it is important to recognize that this study does not prove that antidepressant use causes autism. It is difficult to determine whether the increased risk of ASD is the result of antidepressants or the result of the underlying depression.

Researchers looked at data from more than 145,000 births between 1998-2009. They found that when mothers took antidepressants during the second and third trimesters, the chance that the child would develop ASD was higher when compared to children whose mothers did not take antidepressants. Keep in mind that the overall risk of having a child with autism is 1%. This study suggests that the risk increases to 1.87% if a woman is taking certain antidepressants.

The increase was seen with a specific type of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed antidepressant medicines and include medications like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®).

There are a number of causes of ASD but we don’t know all of them. More research is needed. However, there are some factors that we know increase the chance of ASD:

• Having pregnancy complications. Some research shows that there may be a link between ASD and pregnancy complications that lead to low birthweight, premature birth or cesarean birth.
• Taking certain prescription medicines, like valproic acid or thalidomide, during pregnancy. Taking these medicines during pregnancy has been linked with a higher risk of having a child with ASD.
• Having an older parent. Babies born to older parents are more likely to have ASD.
• Having genes linked to ASD. Researchers are studying a number of genes that may be linked to ASD. Children who have a brother or sister with ASD are more likely to have ASD themselves.
• Having a genetic or chromosomal condition. ASD happens more often in children who also have certain genetic or chromosomal conditions, like fragile X syndrome or tuberous sclerosis.

Important:  If you are pregnant or thinking about getting pregnant and are taking antidepressants, you should not stop taking them until you talk to your health care provider. Together you can look at the possible risks of these drugs on your baby as well as the risk of having your depression come back if you stop taking your medicine. Learn as much as you can about the medicines so you can make the best choice for you and your baby.

Have questions? Email us at AskUs@marchofdimes.org.

Tags: antidepressants, ASD, autism, autism spectrum disorders, depression, depression during pregnancy, medications, selective serotonin reuptake inhibitors (SSRIs)