Minimizing non-genetic causes of birth defects

This post was written by Geoffrey Gordon, MD, PPG – Maternal-Fetal Medicine. 

Birth defects occur in 2-4% of live births. While some women may be at a relatively higher risk of a birth defect in their pregnancy, as conditions can be genetic, the risk of birth defects from non-genetic causes can typically be reduced with appropriate counseling and lifestyle changes.

Non-genetic causes of elevated risk for birth defects include alcohol and tobacco use, certain medications and some medical conditions. For this article, we will focus on risk factors that can be modified and reduced to help prevent birth defects.

Alcohol and tobacco use

Since there is no known safe amount of alcohol use in pregnancy, it is recommended to avoid alcohol.  Alcohol has been linked to Fetal Alcohol Spectrum Disorder. Children affected by this condition have facial abnormalities and varying degrees of neurocognitive delays. 

When we talk about tobacco use, we’re primarily talking about cigarette smoking. Cigarette use has been associated with specific birth defects that include cleft lip and palate, gastrointestinal malformations, limb malformations and certain cardiac malformations. 

­Medications

­Many medications prescribed during pregnancy are safe, but there are many medications that may be prescribed when you aren’t pregnant that should be stopped prior to or in early pregnancy because of their increased risk of causing birth defects. 

Isotretinoin, used to treat acne, is associated with abnormalities of the fetal ears and brain. Some medications used for blood pressure, seizures and mood stabilizers can also increase birth defects.

It’s important that mothers don’t stop any medications without first consulting with their doctor, since some may require transitioning to a different medication to avoid worsening of blood pressure, seizures, etc.

Medical conditions

The two most common medical conditions that increase the risk of birth defects are obesity and diabetes. Both are associated with many different birth defects. The most common birth defects related to obesity and diabetes are those of the heart and spine. With diabetes, specifically, the risk of birth defects is directly related to sugar control.

Decreasing risk

One of the most important and under-utilized prevention methods for reducing birth defect risk is to have a discussion with your OB/GYN prior to attempting to get pregnant. Pre-pregnancy discussions allow for the obstetrician to evaluate the patient’s risk factors and help patients make medication adjustments or lifestyle modifications that can lead to a successful pregnancy. In some cases, your obstetrician may want you to meet with a maternal-fetal medicine physician for further care planning.

Avoiding alcohol and tobacco can reduce the risk of birth defects, as can ensuring that medications are safe (ideally, prior to becoming pregnant or once pregnancy is confirmed). Weight loss and improved sugar control (if diabetic) are also ways to decrease the risk of birth defects.

The Parkview difference

Parkview Women’s and Children’s Hospital offers highly qualified pre-pregnancy and pregnancy care with an exceptional team of OB/GYN physicians. The hospital also offers two full-time Maternal-Fetal Medicine physicians to assist you in pre-pregnancy and pregnancy management.  

If you are concerned about pregnancy exposures or risk factors that may increase your risk of birth defects, the Advanced Perinatal Care Center offers Detailed Anatomical Ultrasounds to evaluate your child and provide you with the reassurance you desire. If a birth defect is identified, the Advanced Perinatal Care Center will work with you to make a care plan for your pregnancy that will include your OB/GYN and any other Pediatric Specialists to provide you and your baby with the highest quality of care.