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Birth Defects Prevention

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Pregnant women should avoid alcohol completely. Alcohol intake by pregnant women can lead to a spectrum of disorders, including fetal alcohol syndrome (FAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD). FAS is characterized by growth retardation, abnormal facial features, and mental retardation. In addition, about 80% of children with FAS have an abnormally small cranium, called microcephaly. Children with FAS also have serious lifelong disabilities, including learning disabilities and behavioral problems.16,17,18 ARND and ARBD are milder versions of FAS.19

Drinking just one alcoholic beverage per day while pregnant has been associated with increased risk of having a child with impaired growth. The potential for harm increases as larger amounts of alcohol are consumed. Even minimal alcohol consumption during pregnancy can increase the risk of hyperactivity, attention deficiency, and emotional problems in the child.20 No safe level of alcohol intake during pregnancy has been determined.21,22

There are many medications that a woman should not use during pregnancy. A healthcare practitioner should review all over-the-counter and prescription medications, as well as any nutritional or herbal supplements. For example, the commonly prescribed acne medication, isotretinoin (Accutane®), a synthetic form of vitamin A, can cause severe birth defects if used during pregnancy.

Excessive noise may have damaging effects on a developing fetus. Many pregnant women are exposed to noise in the workplace.23,24 In one study, the children of women exposed consistently to high levels of occupational noise during pregnancy were more likely to have high-frequency hearing loss (identified at four to ten years of age) than were children whose mothers were not exposed to such noise.25 Noise exposure at these excessive levels (i.e., 85 to 90 decibels) occurs in many occupations, even among women wearing protective hearing devices. Other environmental sources of excessive noise include rock concerts, boom boxes, car stereos, and airport jet traffic.

Women who are obese prior to pregnancy are at increased risk of having an NTD-affected pregnancy. One study showed a twofold or greater risk of NTD-affected pregnancy among women who were obese.26

References

1. MRC Vitamin Study Research Group. Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. Lancet 1991;338:131-7.

2. Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992;327:1832-5.

3. Forrest JD. Epidemiology of unintended pregnancy and contraceptive use. Am J Obstet Gynecol. 1994;170:1485-9.

4. Moore KL. Formulation of the trilaminar embryo. In: The Developing Human. Philadelphia, PA: WB Saunders Co., 1988:55-64.

5. Centers for Disease Control and Prevention. Use of folic acid for prevention of spina bifida and other neural tube defects: 1983-1991. MMWR 1991;40:513-6.

6. Shaw GM, Carmichael SL, Yang W, et al. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol 2004;160:102-9.

7. Shaw GM, Carmichael SL, Yang W, et al. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol 2004;160:102-9.

8. Botto LD, Mulinare J, Erickson JD. Occurrence of congenital heart defects in relation to maternal mulitivitamin use. Am J Epidemiol 2000;151:878-84.

9. Botto LD, Khoury MJ, Mulinare J, Erickson JD. Periconceptional multivitamin use and the occurrence of conotruncal heart defects: results from a population-based, case-control study. Pediatrics 1996;98:911-7.

10. Czeizel AE. Reduction of urinary tract and cardiovascular defects by periconceptional multivitamin supplementation. Am J Med Genet 1996;62:179-83.

11. Werler MM, Hayes C, Louik C, et al. Multivitamin supplementation and risk of birth defects. Am J Epidemiol 1999;150:675-82.

12. Preston-Martin S, Pogoda JM, Mueller BA, et al. Prenatal vitamin supplementation and risk of childhood brain tumors. Int J Cancer Suppl 1998;11:17-22.

13. Velie EM, Block G, Shaw GM, et al. Maternal supplemental and dietary zinc intake and the occurrence of neural tube defects in California. Am J Epidemiol 1999;150:605-16.

14. Hambidge M, Hackshaw A, Wald N. Neural tube defects and serum zinc. Br J Obstet Gynaecol 1993;100:746-9.

15. Cnattingius S, Signorello LB, Anneren G, et al. Caffeine intake and the risk of first trimester spontaneous abortion. N Engl J Med 2000;343:1839-45.

16. Clarren SK, Smith DW. The fetal alcohol syndrome. N Engl J Med 1978;298:1063-7.

17. Jones KL. Fetal alcohol syndrome. Pediatr Rev 1986;8:122-6.

18. Streissguth AP, Aase JM, Clarren SK, et al. Fetal alcohol syndrome in adolescents and adults. JAMA 1991;265:1961-7.

19. Stratton K, Howe C, Battaglia F, eds. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention and Treatment. Washington, DC: National Academy Press; 1996:4-21.

20. Gold S, Sherry L. Hyperactivity, learning disabilities and alcohol. J Learn Disabil 1984;17:3-6.

21. Mills JL, Granbard BI, Harley EE, et al. Maternal alcohol consumption and birth weight: how much drinking in pregnancy is safe? JAMA 1984;252:1875-9.

22. Kaminski M. Maternal alcohol consumption and its relation to the outcome of pregnancy and child development at 18 months. Int J Epidemiol 1992;21(suppl 1):S79-81.

23. Rudolph L, Forest CS. Female reproductive toxicology. In: LaDou J, ed. Occupational Medicine. Norwalk, CT: Appleton & Lange, 1990:275-87.

24. Paul M, ed. Occupational and Environmental Reproductive Hazards. A Guide for Clinicians. Baltimore, MD: Williams & Wilkins, 1993:xviii.

25. Lalande NM, Hetu R, Lambert J. Is occupational noise exposure during pregnancy a risk factor of damage to the auditory system of the fetus? Am J Ind Med 1986;10:427-35.

26. Shaw GM, Todoroff K, Finnell RH, Lammer EJ. Spina bifida phenotypes in infants or fetuses of obese mothers. Teratology 2000;61:376-81.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.