The vast majority of babies born in Anguilla are healthy, and only a small number have birth defects. But almost every parent-to-be worry about their baby having a problem. There are about four thousand different known birth defects. The economic, psychological and other costs associated with birth defects can be very significant to parents and the country as a whole.

Dr. Brett Hodge

What is a birth defect?
A birth defect, also called congenital defect, is something abnormal that is present at birth. These defects can vary significantly from the very mild, like a skin tag, to very severe like defects in the heart. Some birth defects can result in the death of the baby, but the majority of birth defects can be treated. Birth defects can be found before birth, but the majority are detected shortly after birth.

What causes a birth defect?
The cause of most birth defects is unknown. Genetic, nutritional, infectious and other environmental factors (such as radiation, drugs, and toxic chemicals) all contribute to birth defects.
Genetic defects can be caused by errors in one or more genes passed by parents. Some genetic disorders are more common in certain ethnic groups. The older you are, the greater your risk of having a child with a chromosomal disorder. The most common chromosomal disorder is Down syndrome. It should be noted the majority of birth defects occur in parents with no problems and are perfectly healthy.
Rubella (German measles) can cause birth defects. If you did not already have the disease, or had not been vaccinated, you should be vaccinated against rubella at least one month before becoming pregnant.
Sexually transmitted infections can cause serious birth defects. For instance, syphilis can cause birth defects. All pregnant women in Anguilla are tested for syphilis and if positive are treated successfully, thus preventing birth defects.
Pregnant women should avoid fish that have high levels of mercury as exposure to these agents can cause birth defects. Fish that should be avoided include shark and swordfish.
Very high levels of vitamin A (25,000 IU) have been linked with some birth defects.
You should consult with your doctor before using any over the counter medication. If you are taking medication for a medical condition inform you obstetrician.

How common are birth defects?
The exact incidence of birth defects is difficult to determine due to lack of reporting and differences in determining different types of birth defects. Heart defects are the most common type of birth defects.

Preventing birth defects
Some birth defects cannot be prevented. Every woman thinking about becoming pregnant should first see their obstetrician for a pre-pregnancy visit. If you have a medical problem such as diabetes or epilepsy it is advisable to see your doctor months in advance of becoming pregnant so that if changes have to be made they can be done before you become pregnant.
You can decrease your risk of having a baby with a birth defect by taking care of yourself and avoiding harmful substances.
Taking folic acid or eating foods with folic acid can help prevent neural tube defects. These defects result when the coverings over the spinal cord or the brain do not close properly.
Alcohol use during pregnancy is a leading cause of mental retardation. Some babies exposed to large amounts of alcohol during pregnancy develop fetal alcohol syndrome. It is not clear how much alcohol is safe during pregnancy therefore, I encourage all pregnant women to avoid drinking any alcohol.

Screening tests for detecting genetic disorders
A screening test looks for signs that your baby might have a genetic defect. The result of a screening test shows only if the risk is present. It will not tell you if your baby has a defect. Some tests are offered to all pregnant women while others are offered to high risk women. These risks are often based on the medical history, family history and other factors.

Diagnostic tests
If you have an increased risk of having a baby with a genetic disorder, you may be offered one or more diagnostic tests. These tests include amniocentesis and fetal blood sampling. If diagnostic tests show that you will have a baby with a birth defect, your doctor will talk to you about your options.

Conclusion
While the exact cause of birth defects is not known, certain factors are associated with birth defects. It is wise for all would-be-mothers to discuss with their health care provider their risks factors for birth defects and ways of preventing birth defects. Good prenatal care will help the pregnant woman stay healthy and help her detect a birth defect in advance. Birth defects can vary tremendously; some may be very mild while others can be serious requiring specialist care and long-term support and treatment.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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