One in 33 babies in the United States are born with birth defects. But a new study from the Centers for Disease Control and Prevention is raising awareness of ways to lower that risk.<\/p>\n\n\n\n
The study points to five risk factors that public health officials \u2014 and, in some cases, women themselves \u2014 can do something about: obesity, diabetes, smoking exposure, food insecurity and low levels of folate (an essential vitamin that helps the body produce cells).<\/p>\n\n\n\n
According to the study, 66% of women ages 12 to 49 have at least one of these risk factors, and 10% have three or more. The CDC\u2019s findings, published Tuesday<\/a> in the American Journal of Preventive Medicine, are based on responses from 5,374 women who completed the agency\u2019s National Health and Nutrition Examination Survey from 2007 to 2020.<\/p>\n\n\n\n \u201cWe can\u2019t underscore enough how important it is to raise awareness about these risk factors and encourage women to speak with their doctors if they have any concerns or questions before becoming pregnant,\u201d Arick Wang, a health scientist at the CDC and the lead author of the new study, said via email.<\/p>\n\n\n\n She added that the \u201crisks can be lowered through steps like getting the recommended 400 micrograms (mcg) of folic acid daily, healthy diet and exercise, and managing blood sugar.\u201d<\/p>\n\n\n\n Birth defects are the leading cause of death in infants<\/a>, according to CDC data. The risks often start before some women even know they\u2019re pregnant. Though the causes of birth defects are largely a mystery, scientists generally recognize that some combination of genetics, environment and lifestyle factors is responsible.<\/p>\n\n\n\n \u201cThis should be a wake up call to all of us,\u201d said Dr. Michael Warren, chief medical and health officer of March of Dimes, a nonprofit research and advocacy group focused on maternal and infant health.<\/p>\n\n\n\n \u201cWe want to make sure that people have access to nutritious foods,\u201d said Warren, who wasn\u2019t involved in the study. \u201cWe want to make sure that people have safe places to be physically active.\u201d<\/p>\n\n\n\n People with food insecurity can be deficient in nutrients that are vital for a fetus\u2019 organs to develop properly, including folate. For instance, low concentrations of folate in the blood are associated with neural tube defects \u2014 brain or spine defects that develop in the first month of pregnancy. Doctors recommend that people who are pregnant or trying to get pregnant take folic acid, the synthetic version of folate.<\/p>\n\n\n\n Since 1998, the Food and Drug Administration has required that enriched cereal-grain products be fortified with folic acid. Wang, the CDC scientist, said in a press release that the policy likely prevents more than 1,300 babies each year from being born without neural tube defects.<\/p>\n\n\n\n \u201cThe vast majority of birth defects that occur, we still don\u2019t know why they occur,\u201d Nembhard said. \u201cEven when women do everything right \u2014 they don\u2019t smoke, they don\u2019t drink during pregnancy, they monitor caffeine intake, they exercise \u2014 you can still have an outcome that is not what you wanted.\u201d<\/p>\n\n\n\n Warren, who until June served as associate administrator of HHS\u2019 Maternal and Child Health Bureau, said many women might not be aware that conditions like obesity and food insecurity are also risk factors.<\/p>\n\n\n\n Obesity, which affected roughly one-third of the women surveyed, was the most common modifiable risk factor in the CDC study. Scientists aren\u2019t exactly clear on why it\u2019s linked to birth defects, but they suspect it has something to do with changes to a woman\u2019s metabolism \u2014 such as the way her body manages insulin and glucose \u2014 that may lead to abnormal development in the fetus.<\/p>\n\n\n\n \u201cWhen [our] cells are growing and forming organs, we really rely on everything to be working just as it should. And when you disrupt those processes, things can go awry,\u201d Warren said.<\/p>\n\n\n\n High blood sugar from diabetes may also lead to abnormal organ development, he said. And some of the chemicals in cigarette smoke, including nicotine, can reduce the supply of oxygen to the fetus.<\/p>\n\n\n\n Warren said there\u2019s more to be done. He pointed to Mississippi, which declared a public health emergency<\/a> last week over its high infant mortality rates and pledged to eliminate \u201ccare deserts,\u201d where women don\u2019t have access to obstetricians.<\/p>\n\n\n\n Outside researchers lauded the study\u2019s release amid layoffs and proposed funding cuts to the agency.<\/p>\n\n\n\n \u201cWe\u2019re delighted that this study has been ongoing. There were some questions about whether or not it would continue,\u201d said Wendy Nembhard, director of the Arkansas Center for Birth Defects Research and Prevention at the University of Arkansas for Medical Sciences.<\/p>\n\n\n\n The Department of Health and Human Services in March announced the termination of 2,400 CDC employees<\/a>. However, a federal judge issued a preliminary ruling<\/a> on Aug. 12 that blocked the layoffs for certain CDC programs, including the National Center on Birth Defects and Developmental Disabilities \u2014 the group behind the new study. At least 600 CDC employees are still expected to receive permanent termination notices<\/a>.<\/p>\n\n\n\n