Congenital disabilities affect roughly one in 33 infants and result in about 3.2 million birth defect-related disabilities across the world annually, according to the World Health Organisation (WHO) Regional Director for South-East Asia, Dr Poonam Khetrapal Singh.
Probing into congenital disorders, Newcastle-based gynaecologist and obstetrician Dr Peter Chukwu elaborates that birth defects can be defined as structural or functional anomalies that occur during intrauterine life. He says, “These conditions develop prenatally and may be identified before or at birth or later in life.”
Looking at the causes and risks of congenital anomalies, Dr Chukwu explains that while approximately 50% of all congenital disabilities cannot be linked to a specific cause, some contributing factors come into play.
These risk factors, according to WHO, are as follows:
Genetic factors – Genes play an essential role in many congenital anomalies. This might be through inherited genes or from sudden changes in genes known as mutations.
Environmental Factors – This occurs when a pregnant woman is exposed to certain chemicals, pesticides, medication, alcohol, tobacco or even radiation, increasing the risk of having a fetus or neonate affected.
Moreover, WHO states, “Working or living near, or in, waste sites, smelters or mines may also be a risk factor, particularly if the mother is exposed to other environmental risk factors or nutritional deficiencies.”
Infections – Dr Chukwu highlights maternal infections such as syphilis and Rubella, Zika, Parvo B19, Varicellar virus are also significant causes of congenital disabilities in both low and middle -income countries.
While the factors mentioned above play a crucial role, Dr Chukwu adds certain pregnancies associated with an increased risk of congenital anomalies include:
- A family history of a congenital abnormality
- Diabetes mellitus
- Exposure to teratogen
- Multiple pregnancies
- Oligohydramnios and polyhydramnios
But how does one go about preventing the risk of congenital disabilities?
Dr Chukwu enthuses that there are possible measures to lessen the chances of certain birth defects by removing risk factors. According to WHO, important intervention and efforts include:
- Ensuring adolescent girls and mothers have a nutritious diet, including a wide variety of vegetables and fruit, while maintaining a healthy weight. This also means ensuring an adequate dietary intake of vitamins and minerals, and especially folic acid in adolescent girls and mothers;
- Avoid harmful substances, particularly alcohol and tobacco.
- Pregnant women and those of child-bearing age should also avoid travelling to areas experiencing outbreaks of infections associated with congenital anomalies.
- Reducing or eliminating environmental exposure to hazardous substances during pregnancy, including heavy metals and pesticides.
- Diabetic women should control their diabetes prior to and during pregnancy through counselling, weight management, diet, and insulin administration when required.
- Vaccination, especially against the rubella virus, for children and women, is also essential. It is also vital to undergo screening for infections, especially rubella, varicella, syphilis, and treatment consideration.
When it comes to detecting anomalies, there are several tests a woman can opt for. According to Mediclinic, mothers-to-be can go for the following tests to detect possible congenital disabilities:
- Amniocentesis – this is a procedure in which amniotic fluid is extracted from the sac around the unborn baby and tested to detect congenital genetic disabilities.
- Maternal blood test for PAPP-A and free β-HCG – Done at 8-12 weeks.
- Maternal blood test for AFP, HCG and estriol (triple test) – This test is done at 15-20 weeks.
- Cell-free DNA testing or non-invasive prenatal testing (NIPT) – Done any time after ten weeks.
Be sure to visit your local gynaecologist and obstetrician regularly.