Bradenton doctor Karen Matta-Toomey has two little girls, Savannah, 5, and Madelyn, nearly 2.
Because she didn’t know when she would become pregnant, the obstetrics and gynecology specialist at Bradenton’s West Coast OB-GYN followed a course of action before they were born that is exactly what she now recommends to her patients.
She read the ingredients in food and if there were preservatives with long chemical names she avoided them. She ate as many fruits, vegetables and lean meats as she could and tried to avoid deli meats and junk food. She washed her hands often when preparing food.
She exercised moderately and tried to avoid second-hand smoke, pesticides and other chemicals. She also took prenatal vitamins, especially ones that had 400 micrograms of folic acid, which she knew could reduce the risk of spinal and brain defects.
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Her girls turned out perfect, but Matta-Toomey knows a mother can do all the things she did and still have a baby with a birth defect.
One in 33 Florida babies has a defect
In Florida, one out of every 33 babies is born with a major birth defect, according to the Report on Birth Defects in Florida from 1998 to 2007, available at Florida Birth Defect Registry, fbdr.org.
To Matta-Toomey and registered nurse Katie Powers of Manatee Memorial Hospital’s MOMM’s Place, even one baby born with a defect is unacceptable.
But preventing such a problem takes an equal measure of planning, dedication and good fortune, both health experts said.
“There are a lot of things out there that we don’t know what affect they can have,” Matta-Toomey said. “And a baby is developing most of its parts even before a woman even knows she is pregnant.”
“I know a wonderful labor and delivery nurse, who worked for an obstetrician and did her folic acid,” Powers said. “She did everything right and she had a baby with a neural tube defect. So, even with everything in the perfect state, life is full of risks. But you can decrease the risks.”
Microcephaly from Zika, neural tube defect, Down syndrome, congenital heart defect, cleft lip, limb reduction, gastroschisis and fetal alcohol spectrum disorders are all birth defects tracked by the Florida Department of Health, according to the report.
“I really feel sorry for women,” Powers said. “We are advising them to avoid so many things.”
Besides the advice on food, lifestyle, vitamins and hygiene, Powers advises pregnant women to stay away from wild or pet rodents, live poultry, lizards and turtles and to not clean litter boxes, due to the possibility of salmonella and other diseases that animals can carry.
Folic acid a mother’s best friend
The report recommends that women in their childbearing years should take 400 micrograms of folic acid before and during pregnancy to prevent serious birth defects of the brain and spine called neural tube defects.
Commonly known as NTDs, neural tube defects have decreased 18 percent in Florida and folic acid has been a major contributor to that improvement, the report on birth defects states.
A neural tube defect occurs when the structures that form the brain and spinal cord fail to develop properly during the first four weeks of pregnancy. Two of the most common NTDs are anencephaly, incomplete development of the brain and spina bifida, the report says.
Cases of anencephaly, in which the brain does not form, have dropped in Florida to 0.45 cases per 10,000 live births, even below the national average of 2.50 per 10,000, with folic acid a major factor.
Women of childbearing age can also add lentils, dried beans, peas, nuts, broccoli, spinach, collard and turnip greens, okra, Brussels sprouts and asparagus to their diets to boost their folic acid, even as they take the 400 micrograms supplement, according to the report.
Obesity plays a role in several defects
“We know obesity has a tremendous possibly negative effect on a pregnancy,” Powers said. “Obese mothers are at risk for many things.”
Mothers who are obese have a higher risk of having a baby with a congenital heart defect, which range from 2.8 to 5.3 per 10,000 live births in Florida, the report states.
Also, mothers should avoid exposure to tobacco smoke and taking anti-seizure or anti-depressant medications to cut the risks of congenital heart defects.
When part of an arm or leg doesn’t form, occurring in Florida in about 1.8 per 10,000 live births, the baby is said to have limb reduction. Again, researchers found that mothers with an obese pre-pregnancy body mass index had a slightly higher risk of having a baby with limb reductions.
Zika infection poses a risk
The Zika virus, which was detected in parts of Florida last year, can cause a birth defect called microcephaly, which results in babies having smaller brains, according to the Centers for Disease Control and Prevention.
Pregnant women are advised to avoid mosquito bites and avoid sexual transmission with a partner who has traveled to a Zika-impacted area, as the virus can be contracted through sex, the CDC has determined.
Age of mother can impact baby
The prevalence of Down syndrome, caused by a baby having an extra copy of chromosome 21, has not changed significantly in Florida from 1998 through 2007, remaining at roughly 13 per 10,000 live births, the same as the national average, the report states.
When women conceive after 40 years of age they have a 10-fold risk of having a child with Down syndrome.
On the other end of the age spectrum, teen mothers are at risk for gastroschisis, which is when the intestines form in the umbilical cord and then move inside a fetus’ abdomen. The defect, at 3.51 per 10,000 live births, has a high survival rate with surgery, but affected children may have lifelong problems digesting food,.
Smoking and alcohol linked to defects
Cleft lip and cleft palate defects, which in Florida occur in about eight per 10,000 live births, occur when parts of the mouth fail to form properly. Pregnant women who smoke are significantly more likely to have an infant born with cleft palate.
Fetal alcohol spectrum disorders, for which rates in Florida are unknown, come from consumption of alcohol during pregnancy and can impact physical features and cause behavior abnormalities, according to the report.
Preventing birth defects
- Take 400 micrograms of folic acid daily.
- Begin prenatal care in the first trimester.
- Talk to a health care adviser about weight goals and address chronic diseases
- Wash hands before and after preparing food.
- Avoid unpasteurized milk and cheese or foods made from them.
- Wear long-sleeved shirts and long pants when outside to avoid mosquitoes.
- Avoid wild or pet rodents, live poultry, lizards and turtles.
Information supplied by the Florida Department of Health