Laura Twist


January is National Birth Defects Prevention Month.

According to the Centers for Disease Control, approximately one in every thirty-three children born in the U.S. today will have some form of birth defect. Medical research and advances have significantly improved the overall prognosis for many children born with birth defects. Additionally, we have identified some simple steps expectant mothers can take to reduce the likelihood of birth defects and improve overall outcomes.

- Establish healthy habits and manage any medical conditions prior to pregnancy. Some medications are not safe to take in pregnancy, and some medical problems such as hypertension and diabetes can worsen in pregnancy. It is important to visit a healthcare provider prior to becoming pregnant, to discuss which medications are best for you and to optimize your health. Your doctor can also check prenatal labs and screen for certain genetic conditions prior to even becoming pregnant.

- Before you get pregnant, try to reach a healthy weight. Getting regular exercise and eating well are beneficial in so many ways. Obesity is the most common health care problem in women of reproductive age, with approximately 58% of women between 20-39 years old qualifying as overweight or obese. Particularly in pregnancy, being overweight or obese can have serious implications. Certain birth defects such as spina bifida, heart anomalies, and cleft palate are more common in obese patients. Additionally, ultrasound detection of birth defects can be limited when you carry extra weight.

- Take appropriate vitamin supplements. Reproductive age women should take 400mcg of folic acid every day. This can be found in over-the-counter vitamins, as well as fortified breads and cereals. The benefits of folic acid supplementation in pregnancy have been well established. Folate is a B vitamin, which is necessary for the proper development of baby’s brain and spinal cord. Getting enough folate prevents up to 70% of neural tube defects such as spina bifida and anencephaly. In reality, nearly half of all pregnancies are unintended, so taking a daily multivitamin with adequate folic acid is universally recommended. Make sure the vitamin you’re taking has 400mcg or 100% of the daily value of folic acid. Some women require more, so check with your healthcare provider.

- Make sure you are up-to-date on appropriate vaccines. Pregnant women are recommended to be vaccinated against influenza with the flu shot. Of note, the nasal spray is not safe as it contains live, attenuated influenza virus. It is also recommended that all pregnant women receive the Tdap vaccine in the third trimester of each pregnancy, to protect their newborn against pertussis (whooping cough). Anyone taking care of the newborn, especially within the first 6 weeks of life, should also be up to date on their vaccines before the baby is born. These simple steps can help protect the infant from a potentially life-threatening illness.

- Avoid toxic substances. Smoking during pregnancy, and even in the month prior to conception, is associated with premature birth and certain birth defects such as cleft lip and palate. Fetal alcohol spectrum disorders are a group of conditions that primarily include problems with behavior and learning but can have physical manifestations as well. There is no amount of alcohol that is considered safe in pregnancy, so all women with the potential of becoming pregnant are advised to avoid alcohol. Certain heavy metals, such as mercury have lasting health effects for an unborn baby including neurological problems, hearing and vision loss. Pregnant women are encouraged to avoid foods high in mercury, especially swordfish, shark, king mackerel and tilefish. These birth defects are completely preventable if toxic substances are avoided. Talk to your provider if you have questions about how to get healthy.

- Get good prenatal care. Working with a qualified obstetrics provider before and during pregnancy can reduce complications and catch potential health concerns for moms and babies early. While not all birth defects can be prevented, early detection and treatment are key. Efforts are being made to increase access to care and encourage women to get prenatal care earlier.

Grants recently awarded to St. James Healthcare in Butte, St. Vincent Healthcare in Billings, and other hospitals throughout the state are steps in the right direction in terms of reducing birth defects and giving every mother and baby the best start possible.

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Dr. Twist is an obstetrician and gynecologist with SCL Health Medical Group - Butte OB/GYN (406-496-3627) who provides comprehensive women’s health care. She is committed to building relationships with her patients in Southwest Montana. 


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