A recent study by the Centers for Disease Control and Prevention (CDC) reveals that many birth defects could be prevented by addressing certain risk factors. The study, published in the American Journal of Preventive Medicine, focuses on modifiable risks that can impact fetal development.

The CDC study identifies five key risk factors: obesity, diabetes, exposure to smoking, food insecurity, and insufficient folate levels. These are factors that public health initiatives and individual women can possibly influence.

according to the research, 66% of women between the ages of 12 and 49 have at least one of these risk factors, while 10% have three or more.The findings are drawn from the CDC’s National Health and Nutrition Examination Survey, which included data from 5,374 women between 2007 and 2020.

Arick Wang, a health scientist at the CDC and the lead author of the study, stated, “We can’t 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.”

Wang also noted that, “risks can be lowered through steps like getting the recommended 400 micrograms (mcg) of folic acid daily, healthy diet and exercise, and managing blood sugar.”

Birth defects remain the leading cause of death in infants,according to CDC data. These issues frequently enough arise in the early stages of pregnancy, sometimes before a woman is even aware she is pregnant. While the exact causes of birth defects are not fully understood, they are generally believed to result from a combination of genetic, environmental, and lifestyle factors.

Expert Commentary on Reducing Risks

dr. Michael Warren, chief medical and health officer of March of Dimes, emphasized the importance of access to resources. “This should be a wake up call to all of us,” 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.

“We want to make sure that people have access to nutritious foods,” said Warren, who wasn’t involved in the study. “We want to make sure that people have safe places to be physically active.”

“When [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,”

food insecurity can lead to deficiencies in essential nutrients, such as folate, which are crucial for fetal development. Low folate levels are linked to neural tube defects, which affect the brain and spine during the first month of pregnancy. Medical professionals typically advise women who are pregnant or trying to conceive to take folic acid, a synthetic form of folate.

Since 1998, the food and Drug Administration (FDA) has mandated the fortification of enriched cereal-grain products with folic acid. According to Wang,this policy is estimated to prevent over 1,300 cases of neural tube defects each year.

Wendy Nembhard, director of the Arkansas Center for Birth Defects Research and Prevention at the University of Arkansas for Medical Sciences, acknowledged the complexities involved. “The vast majority of birth defects that occur, we still don’t know why they occur,” Nembhard said. “Even when women do everything right – they don’t smoke, they don’t drink during pregnancy, they monitor caffeine intake, they exercise – you can still have an outcome that is not what you wanted.”

Warren noted that many women may not realize that conditions like obesity and food insecurity are meaningful risk factors.

Obesity, affecting approximately one-third of the women in the CDC study, was the most prevalent modifiable risk factor. While the exact mechanisms are unclear, scientists believe obesity-related metabolic changes, such as those affecting insulin and glucose management, may disrupt fetal development.

Warren explained, “When [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,”

high blood sugar levels from diabetes can also impair organ development, while chemicals in cigarette smoke, including nicotine, can reduce oxygen supply to the fetus, Warren added.

Warren also highlighted the need for broader systemic changes, referencing Mississippi’s declaration of a public health emergency due to high infant mortality rates and its commitment to addressing “care deserts” where access to obstetricians is limited.

The study’s release has been praised by researchers, particularly in light of recent layoffs and proposed funding cuts to the CDC.

“We’re delighted that this study has been ongoing. There where some questions about whether or not it would continue,” said Wendy Nembhard, director of the Arkansas Center for Birth Defects research and Prevention at the University of Arkansas for Medical Sciences.