Birth Defects Affect More Than 8 Million Children Annually

More than 3 million under 5 die each year worldwide, report finds

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By Kathleen Doheny
HealthDay Reporter

MONDAY, Jan. 30, 2006 (HealthDay News) -- Each year, more than 8 million children worldwide are born with a serious birth defect that is genetic or partly genetic in origin, according to the first in-depth analysis of the global impact of birth defects.

Those 8 million children represent about 6 percent of total births around the world, according to the report released Monday by the March of Dimes.

And at least 3.3 million children less than 5 years old die every year from serious birth defects, according to the report, titled "The March of Dimes Global Report on Birth Defects: The Hidden Toll of Dying and Disabled Children."

While the March of Dimes is often thought of as a U.S. organization, in 1998 it established its Office of Global Programs and now works on four continents to help prevent birth defects.

"This is the very first report ever to document the harsh reality of birth defects worldwide," said Christopher P. Howson, vice president for Global Programs at the March of Dimes. "We wanted to document the toll because it is hidden.

"We wanted to bring this hidden toll to light," he added. "We wanted to bring this toll to the attention of governments, international health agencies and the public."

While there are many programs around the world to help prevent birth defects, Howson said, "these activities are fragmented, piece-meal. And what has been lacking has been the data to provide an impetus to get attention for the problem."

The impact of birth defects is especially severe, the report noted, in "middle- and low-income countries." More than 94 percent of serious birth defects and 95 percent of the deaths of these children occur in such countries.

For the year 2001, five birth defects caused wholly or partly by genetics accounted for about 26 percent of the following birth defects: congenital heart problems; neural tube defects such as spina bifida; hemoglobin disorders, including sickle disease; Down syndrome; and a disorder called glucose-6-phosphate dehydrogenase deficiency, or G6PD, the report found.

Worldwide, the birth prevalence of all genetic birth defects combined range from a high of 82 per 1,000 live births in low-income nations to a low of 39.7 per 1,000 live births in high-income countries.

Exact figures for birth defects due to damage after conception, such as fetal alcohol syndrome or syphilis contracted from the mother, weren't computed, but were estimated to be in the hundreds of thousands every year, the report said.

For the report, the authors used a database that detailed the prevalence and number of birth defects in 193 countries.

Howson said the data didn't allow for precise comparisons of birth defects prevalence among countries; more information is needed to do that.

The report authors made a number of recommendations to reduce the toll of birth defects. They included interventions such as folic acid supplementation for women of childbearing age to prevent neural tube defects; immunization against rubella, or German measles, a cause of birth defects; and iodination of salt to prevent congenital low thyroid.

The report also advised that nations and officials need to be better educated about birth defects and their prevention.

"Seventy percent of birth defects could be prevented, treated or ameliorated if the recommendations in this report are adopted," Howson said.

Howson said the U.S. experience proves such education and intervention measures work. "What we have seen in the U.S. from 1960 to 2001 is a 62 percent reduction in mortality from birth defects," he said.

Dr. Jose Cordero, director of the U.S. Centers for Disease Control and Prevention's National Center on Birth Defects and Developmental Disabilities, said the report should help "policymakers realize the impact that birth defects have on infant mortality."

He also said he thought it would "help people understand that birth defects can be prevented and that there are many missed opportunities for preventing birth defects." He, too, called for folic acid supplementation and the rubella vaccine, among other measures.

While the report is aimed at policymakers and public health officials, Howson said individuals can do much to help prevent birth defects. Women of childbearing age, whether trying to conceive or not, should take 400 micrograms of folic acid a day, a level easily gotten from most vitamins, he said.

Early prenatal care is crucial, too, he said, as are avoiding alcohol and smoking during pregnancy.

More information

To learn more about birth defects, visit the March of Dimes.

SOURCES: Christopher P. Howson, Ph.D., vice president, Global Programs, March of Dimes, White Plains, N.Y.; Jose Cordero, M.D., M.P.H., director, National Center on Birth Defects and Developmental Disabilities, U.S. Centers for Disease Control and Prevention, Atlanta; Jan. 30, 2006, "March of Dimes Global Report on Birth Defects: The Hidden Toll of Dying and Disabled Children"

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