[Medical Q&A] Can birth defects be prevented?

Author: Zhao Quming, deputy chief physician, Children's Hospital Affiliated to Fudan University

Reviewer: Huang Guoying, Chief Physician and Professor, Children's Hospital Affiliated to Fudan University

The health status, lifestyle, diet and medication of the prospective parents may affect the baby. Although there is no way to completely avoid birth defects, the following 5 points can effectively reduce the risk of birth defects in the baby.

1. Make sure you take 0.4 mg of folic acid every day: Folic acid is a B vitamin that helps prevent neural tube defects (such as anencephaly and spina bifida) and also has a certain preventive effect on congenital heart disease. It is recommended that women who are planning to become pregnant start taking folic acid at least one month before pregnancy and continue taking it during pregnancy. In addition to taking vitamins containing folic acid, you can also consume more foods rich in folic acid.

2. Take medication properly during pregnancy: When preparing for pregnancy, you may be taking related medications for various reasons. At this time, you need to consult a specialist or pharmacist about the safety of the current medications for the fetus. Although most medications are safe to take during pregnancy, some medications, such as some anti-epileptic drugs, cholesterol-like drugs, anti-allergic drugs, sleeping pills and anti-cancer drugs, have the risk of causing birth defects. At the same time, it is not recommended for women preparing for pregnancy to stop taking medications on their own before consulting a doctor, because the physical health of pregnant women is also very important.

3. Ensure the necessary vaccination: timely vaccination with the right vaccines during pregnancy will help ensure the health of pregnant women and fetuses. Inactivated vaccines are relatively safe for pregnant women. The "Technical Guidelines for Influenza Vaccination in China (2018-2019)" issued by the Chinese Center for Disease Control and Prevention recommends that pregnant women or women who are preparing to become pregnant during the influenza season receive influenza vaccines, and pregnant women can receive them at any stage of pregnancy. In addition, imported hepatitis B vaccines, inactivated polio vaccines used for enhanced or emergency vaccination during epidemics, rabies vaccines that need to be vaccinated due to exposure risks, tetanus vaccines and other inactivated vaccines can also be vaccinated during pregnancy. At the same time, there is a great possibility that the antibodies produced by the vaccine will pass through the placenta to immunize the baby. In general, expectant mothers need to receive the right vaccines at the right time under the guidance of a doctor.

4. Try to achieve a healthy weight and blood sugar level before pregnancy: Obesity increases the risk of several serious birth defects and other pregnancy complications. Women who are obese before pregnancy (BMI ≥ 30) are also at higher risk of complications during pregnancy. In addition, if the mother has diabetes, it may also increase the risk of birth defects. When preparing for pregnancy, you need to consult a specialist for advice on controlling your weight and blood sugar.

5. Avoid exposure to harmful substances such as tobacco and alcohol during pregnancy, and prevent infection: Although there is no known safe amount of alcohol during pregnancy, exposure to alcohol may increase the risk of birth defects and other pregnancy complications. At the same time, smoking and even exposure to secondhand smoke may also cause harmful substances to damage the placenta and/or enter the fetus. In addition, some diseases that expectant mothers are infected with during pregnancy, such as rubella virus, cytomegalovirus, herpes simplex virus and some sexually transmitted diseases, may also cause harm to the fetus and even increase the risk of birth defects. At this time, you should see a doctor in time and receive regular examinations and treatment.