Global child health could be significantly improved and infant and child mortality reduced by focusing on preventable birth defects, according to a recent review published in the June 2014 edition of Seminars in Fetal and Neonatal Medicine.
Led by researchers at Emory University's Rollins School of Public Health, the review focused on preventable birth defects including those caused by the rubella virus, folate deficiency, prenatal alcohol exposure, insulin dependent diabetes mellitus, rhesus hemolytic disease (Rh factor), use of the drug valproic acid during pregnancy, and the major upward shift of births to women over age 35.
"We hope our findings will assist public health practitioners and policy makers in developing population-based birth defects surveillance systems and prevention programs, and we urge intensified efforts to accelerate the pace of these programs," says lead researcher Vijaya Kancherla, PhD, a birth defects epidemiologist and instructor in Emory's Department of Epidemiology.
Kancherla and her team bring to the forefront the burden of major birth defects and challenges faced by current prevention programs.
"There is a three-fold increased risk of major malformations among infants born to diabetic mothers compared to mothers without diabetes. This is a huge concern. A multipronged approach with increased awareness among health care professionals, periodic screening for diabetes in women, and timely therapeutic management, can prevent many birth defects associated with maternal diabetes," she says.
Birth defects are one of the leading causes of infant mortality in the world, causing more than three million deaths among children less than five years of age. Middle and low-income countries have twice the prevalence of birth defects and associated mortality than developed countries.
The review calls for active and effective interventions that promote prenatal care, and encourages promotion of optimal maternal health factors necessary to reduce birth defects that are easily preventable. There is an urgent need, say the researchers, for countries with high rates of birth defects, such as India and China, to implement simple and cost-effective strategies (e.g., mandatory folic acid fortification) to reach all women of reproductive age equitably.
"Pediatricians, researchers and public health practitioners in the field of birth defects should intensify prevention efforts. Funding for these prevention programs will lead to significant returns over time," says Godfrey Oakley Jr., MD, co-author and professor at Emory's Rollins School of Public Health. "The effort takes both political will and commitment by communities to implement these initiatives globally."