As an expectant mom, you want to keep yourself and your baby healthy. You especially want to protect against birth defects, which starts with regular prenatal care, says Georges Sylvestre, M.D., Assistant Professor of Clinical Obstetrics and Gynecology. “The ideal time to seek prenatal care is before you become pregnant,” Dr. Sylvestre says.
Birth defects are physical or genetic abnormalities that range from mild to severe, and may affect how your baby’s body looks, functions, or both. They can develop at any stage of pregnancy, although most occur during the first three months, as a baby’s organs form. Some birth defects, like Down syndrome, are detectable during pregnancy, while others, like cleft lip, don’t appear until birth. Although cleft lip is an easily recognizable birth defect, heart problems and hearing loss require special tests to diagnose.
Medical science doesn’t fully understand what causes birth defects, although certain factors like poor underlying health, certain medications, environmental exposures, and genetics play a role, Dr. Sylvestre says. “The most common risk factor is taking medication while you're pregnant to control hypertension, diabetes, or depression and anxiety. Women who are actively trying to get pregnant should consult their physician first, especially when they have an underlying condition.”
Uncontrolled diabetes is another major cause of birth defects. “A woman who has uncontrolled diabetes has a 10% to 15% risk of having a baby with a serious heart or spinal defect,” Dr. Sylvestre adds. “If we can control the diabetes before she becomes pregnant, we can bring down those risks.”
Other factors that may increase your risk of having a baby with birth defects:
Of course, you could have one or more of these risks and not have a baby with a birth defect. Or, you could have none of these risks and have a baby with a birth defect. Also, if you are an older mother or have a family history of birth defects, then you may want to consult a genetic counselor before conceiving. You may also want to talk to your doctor about how to lower your risk.
You may request screenings like maternal blood tests and ultrasounds that can identify fetal birth defects or genetic disorders while you are pregnant. “Early in pregnancy, we screen for infections like syphilis, sometimes toxoplasmosis. Sometimes treating those infections in early pregnancy can reduce the risk of birth defects,” Dr. Sylvestre says.
Additionally, most pregnant women have two sonograms: one at the end of the first trimester, and another at 18-20 weeks. “Women who are of advanced maternal age, have taken toxic medication, or used drugs, alcohol, or marijuana, should be screened specifically with an early anatomy sonogram at 18 to 20 weeks,” he add.
If screening identifies an abnormality, or if your pregnancy is considered high risk, then your doctor will likely recommend a diagnostic test, including:
Not all birth defects are preventable, but you can improve your chances of having a healthy baby by: