9 Ways to Reduce the Risk of Birth Defects

Although not all defects can be avoided, there are some preventive steps you can take.

Medically reviewed in December 2020

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Birth defects are health conditions that are present at birth. They may include those that are visible (such as extra fingers or toes), or those that may not be immediately apparent (such as hearing loss). Birth defects usually have a genetic basis, but some are caused by exposure to certain medications, infections and chemicals during pregnancy. Still others are related to a combination of factors or are caused by unknown factors.

Birth defects are common. They touch one out of every 33 babies born each year in the United States, or nearly 120,000 babies each year overall. They are also the leading cause of death in infants in the US. While not all birth defects are fatal, some can cause lifelong health problems.

Not all birth defects can be prevented, but there are some things a mother-to-be can do before and during pregnancy to lower the risk of certain birth defects, says Tracy Nelson, MD, an OBGYN with Grand Strand Medical Center in Myrtle Beach, South Carolina.

Here’s a look at some of the most common birth defects, plus healthy tips for expectant mothers.

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There are many different types of birth defects

Birth defects can impact all different parts of the body. Some have minor health implications, while others have more serious effects. “There are major and minor birth defects,” says Dr. Nelson, “with major birth defects being anything that may require additional treatment or have major social implications.”

Some birth defects are related to structural development, such as:

  • Cleft lip or palate
  • Heart defects: missing or misshaped valves, chambers, arteries or veins 
  • Abnormal limbs: clubfoot, additional fingers and toes or underdeveloped limbs
  • Neural tube defects: issues with the growth and development of the brain and spinal cord like spina bifida or anencephaly

Other defects can impact how certain parts of the body work, and are known as functional or developmental defects, such as:

  • Nervous system or brain problems that affect intellectual, developmental and behavioral functioning: Down syndrome, Prader-Willi syndrome or Fragile X syndrome
  • Sensory problems: hearing loss, blindness or deafness
  • Metabolic disorders: phenylketonuria or hypothyroidism

The Centers for Disease Control and Prevention and the National Institutes of Health have more information about the different types of birth defects and how they may affect growth and development.

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See your doctor regularly

All women who are planning to get pregnant should see their gynecologist every year—even if they don’t need a Pap smear—to discuss changes in family history, receive a pelvic exam (in some cases) and complete any recommended genetic testing. You can also discuss fertility plans, sexual concerns and vaccinations. If you’re planning to start a family, certain blood tests may be able to detect possible genetic issues that could lead to birth defects down the road.

Once you are pregnant, call your doctor right away so you can start perinatal care. Seeking routine care can help your doctor catch any potential issues, like infections or conditions that could cause problems for you or the growing fetus. Routine blood work can detect whether or not a woman is protected from rubella (German measles), of if she has human immunodeficiency virus (HIV) or tuberculosis, all things that could affect the health of your baby. Regular ultrasounds will also be a part of your perinatal care plan. These tests can help your doctor spot any heart defects and monitor how the fetus is developing.

After your initial OBGYN appointment, your doctor will discuss how often you’ll need to come in for ultrasounds and other testing, or if any specialist visits may be necessary. It’s important to stick to any and all appointments so your healthcare providers can monitor your health and how the fetus is progressing.

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Take 400 micrograms of folic acid every day

The first thing Dr. Nelson recommends expectant mothers do is to take a daily folic acid supplement. Folic acid, a form of the B vitamin folate, is essential for preventing brain and spinal birth defects like anencephaly and spina bifida. If you’re planning to become pregnant, go ahead and add 400 to 800 micrograms of folic acid supplementation to your diet, and be careful you don’t take too much unless your doctor prescribes an increased amount. If you haven’t started before you become pregnant, start taking a daily prenatal vitamin that contains folic acid as soon as you learn you’re pregnant.

Certain foods like fortified cereal, leafy greens, citrus and pastas may also contain large amounts of folic acid or folate, so you may want to ramp up your intake of those nutrient-rich foods, too.

Not sure which prenatal vitamin or supplement to take? Ask your OBGYN for recommendations and samples so you can choose the one that’s right for you. Some women may need more folic acid than others. “Women who have a family member or a previous child with neural tube defects, or women who have conditions like celiac disease or inflammatory bowel disease may need to take more,” says Dr. Nelson.

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Avoid alcohol

No amount of alcohol during pregnancy is considered safe, so it’s best to avoid it completely. Any alcohol consumed by a mother can pass to her baby through the umbilical cord and increase the risk of miscarriage, stillbirth and a constellation of physical, behavioral and intellectual disabilities known as fetal alcohol spectrum disorders (FASDs).

Those with FASDs may experience a variety of issues as infants and throughout their lives, including:

  • Abnormal facial features
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Coordination issues
  • Overactive behavior
  • Intellectual disabilities
  • Vision or hearing problems
  • Problems with the heart, kidneys or bones

If you’re having trouble with alcohol dependence, talk to your doctor or reach out to the Substance Abuse and Mental Health Services Administration for free, confidential, 24/7 information and resources that can help you quit.

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Stop smoking

Your own health is at risk when you smoke but smoking during pregnancy can also cause harm to a developing fetus. Heart and kidney defects as well as cleft lip, cleft palate, gastroschisis (an intestinal defect) and incomplete enclosure of the abdominal wall have been associated with smoking during pregnancy, says Dr. Nelson. Lighting up while you’re expecting can also increase the risk of preterm birth and sudden infant death syndrome.

The best thing to do is to quit smoking before you are pregnant. If you don’t smoke, steer clear of anyone who does, since secondhand smoke can cause harm, too. Remember that it’s never too late to quit, even if you are pregnant.

If you looking to quit or you’re not sure how to start, talk with your doctor or call 1-800-QUIT-NOW for free coaching, a quit plan, educational materials and a list of local smoking cessation resources in your area.

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Avoid marijuana and illicit drugs

Illicit drugs can cross the placenta and pass through to the developing fetus, causing harm.

In addition to miscarriage, growth problems, premature birth and stillbirth, cocaine might be associated with birth defects of the brain and spinal cord, urinary tract and bones. The impact of marijuana on a growing fetus is still unclear, but amphetamines—like speed, or crystal meth—might be connected to certain heart defects and poor growth.

Talk with your doctor if you are still using illicit drugs so the two of you can work through a recovery plan.

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Practice infection prevention

Pregnant women are more at risk for certain infections, thanks to altered immune systems. Some of these infections can cause serious illness, birth defects like microcephaly or hearing loss and disabilities that can last a lifetime. There are variety of steps to take to lower your risk of contracting infections:

  1. Avoid areas with risk of Zika when pregnant.
  2. Reduce your risk of cytomegalovirus, a virus that can cause a fever, sore throat, fatigue and swollen glands, by limiting your exposure to saliva and urine from children.
  3. Avoid soft, unpasteurized cheeses and deli meats to lower your chances of contracting listeria, an infection that’s usually caused by consumption of contaminated food and is accompanied by fever and other flu-like symptoms.
  4. Steer clear of cat litter to protect yourself from toxoplasmosis, a serious disease caused by a parasite that can lead to fetal organ damage. If you have to change cat litter, use gloves and wash your hands thoroughly afterwards.
  5. Avoid contact with rodents like mice, hamsters or guinea pigs. These animals could carry the lymphocytic choriomeningitis virus, which in serious cases could lead to meningitis, encephalitis or inflammation of the brain.
  6. Keep an eye on food recalls and avoid any contaminated foods.

Always practice good hygiene while pregnant, too. Wash your hands often, especially after using the bathroom, touching raw meats or veggies, handling pets or playing with children.

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Get your vaccinations

If you contract an infection like rubella during pregnancy, it can potentially lead to poor fetal growth, heart defects, hearing loss or developmental problems. Chickenpox may also increase the risk of miscarriage, eye damage, limb defects, blindness or intellectual disabilities, so it’s important to make sure you are up to date on the recommended vaccinations.

Prior to becoming pregnant, discuss your vaccination history with your OBGYN so you can get any necessary shots that are unsafe to administer during pregnancy, like the MMR (measles-mumps-rubella) vaccine. Once you are pregnant, it’s important to stay up to date with any vaccines like the Tdap vaccine (to protect against adult tetanus, diphtheria and acellular pertussis) as well as shots for the flu, hepatitis B or any others you may need if you have to travel overseas while pregnant.

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Manage chronic conditions

If you have any chronic conditions, like high blood pressure or diabetes, it’s important to get them under control before you become pregnant.

“Pregnancy is a stressor, so for those with diabetes, we can get you on a really effective insulin regimen before pregnancy,” says Dr. Nelson. “But once you’re pregnant, we’re chasing our tail to try to control your blood sugar with a growing pregnancy.” If blood glucose levels are too high in women (usually those who are already dependent on taking insulin), there’s an increased risk of heart, brain and spine defects in the fetus as well as a greater risk of miscarriage, premature delivery and large birth weight.

Uncontrolled chronic high blood pressure prior to pregnancy can slow fetal growth, increase the risk of preterm delivery, placental abruption, low birth weight or preeclampsia. Obesity and autoimmune disorders may also increase the risk of birth defects.

Regardless of your condition, make sure you’ve consulted with the appropriate doctors prior to pregnancy about developing a management plan. If you do become pregnant, see your doctor right away to discuss safe treatment options.

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Discuss all medications and supplements with your doctor

It’s always a good idea to keep your doctors in the loop when it comes to the medications and supplements you’re taking, but you’ll want to be especially forthcoming during pregnancy. What you put in your body during the first 12 weeks of your pregnancy is particularly important, since your baby’s vital organs are developing during that time. Many medications have not been tested for safety during pregnancy and others have known side effects, like heart or brain defects.

Make a list of every over-the-counter or prescription medication, vitamin, dietary supplement or herbal product you’re taking and let your OBGYN know about them as soon as you become pregnant. If you’re trying to become pregnant, it’s a good idea to discuss your list at a routine OBGYN visit. Your doctor may suggest alternative treatments, lower doses or you may be advised to stop taking the medication altogether. Your doctor can discuss the risks and benefits for any potential medications. Remember: you should never start or stop taking any medication without first discussing it with your doctor, pregnant or not.

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