Preventing Birth Defects : Healthy Mothers, Healthy Babies

by Food and Drug Administration (FDA)

(Page 2 of 3)

Only a few foods are completely off-limits during pregnancy. These include raw or undercooked meat, such as "pink-in-the-middle" burgers, and raw or undercooked seafood. Bacteria from these can cause severe food poisoning, which is dangerous to a fetus and very unpleasant for the mother.

Soft drinks, coffee, tea, and other caffeinated drinks can be used in moderation. Although large doses of caffeine have caused skeletal defects in rats, one or two cups of coffee daily are not considered dangerous for developing fetuses.

Alcohol should be avoided at all times during pregnancy because it leads to low birth weight and can cause deformities as well.

According to the March of Dimes, alcohol is the most common known cause of fetal damage in the country and the leading cause of preventable mental retardation. Pregnant women who drink alcohol, especially in large amounts, put their babies at risk for fetal alcohol syndrome, which causes growth retardation, facial deformities such as a small head, thin upper lip, and small jaw bone, an underdeveloped thymus gland, and mental deficiencies or developmental delays.

If a woman has had a glass or two of wine before finding out she was pregnant, she probably has not harmed her child. But since no one knows the exact amount of alcohol that is dangerous, it's best to avoid alcohol when pregnancy is possible.

Healthy Mothers, Healthy Babies

A pregnant woman who has a serious medical condition may face a greater than normal risk that her child will have a birth defect.

Diabetes, for example, can complicate a pregnancy in many ways. Women who must take insulin daily to control their blood sugar are three or four times more likely to have a baby with major birth defects than are other mothers. That's not to say they should abandon insulin, however. Without it, many diabetic women and their babies wouldn't survive pregnancy at all.

Birth defects among diabetics can be greatly reduced if women get their blood sugar levels under control before becoming pregnant and strictly manage their diets throughout pregnancy. Gestational diabetes, which develops during pregnancy, can also be harmful to mother and child, but it can be controlled through diet or medication.

Epilepsy also increases a woman's chance of having a baby with a birth defect. It's not clear whether the disease itself or the drugs used to control it cause malformations, but in either case, the woman's neurologist and obstetrician should work together to find the safest course of treatment for the epilepsy and pregnancy.

Rubella, toxoplasmosis, cytomegalovirus, and syphilis can cause birth defects in the infants of women who have these infectious diseases. Rubella infection during early pregnancy can cause abnormalities of the heart, eyes and ears. Any woman planning a pregnancy should be tested for rubella immunity and vaccinated if necessary. She must wait three months after vaccination before becoming pregnant, however, because the vaccine itself can endanger a developing fetus.

Toxoplasmosis is transmitted only through raw meat and cat feces, both of which pregnant women should try to avoid. The disease causes malformations of the brain, liver and spleen if a fetus becomes infected in the first trimester.

If a woman has syphilis, she should be treated with antibiotics before pregnancy. If not treated by at least the fourth month, syphilis can cause bone and tooth deformities in the baby, as well as nervous system and brain damage.

Cytomegalovirus (CMV) is a herpes virus that causes no real problem — and sometimes not even symptoms — for adults and children. In pregnancy, however, it can damage the fetus' brain, eyes or ears. Because most people contract the infection, whose symptoms are very much like a cold, when they are children, most adults are immune to it. Pregnant women who do not know if they've had CMV and who work with large groups of young children should discuss the situation with their health-care providers.

Sometimes it is not a disease that causes birth defects, but the medication used to treat it. Unfortunately, no one knows for certain how most drugs will affect a developing fetus. Historically, most women of childbearing age have been excluded from clinical trials of new drugs, and, although that is changing, drug manufacturers are understandably reluctant to involve pregnant women in clinical trials for new drugs. Therefore, the effects of many drugs are not known until they are in wider use after market approval.

To be on the safe side, a pregnant woman shouldn't take any drug unless it is absolutely necessary and not until she's checked with her health-care provider. However, even physicians have little information when prescribing medication for pregnant women. What is known about most drugs in pregnancy is based either on animal studies or on reports of problems after the drug is on the market. To give guidance about pregnancy safety, FDA requires that manufacturers include in the professional labeling for each drug which one of several categories, reflecting information from studies available at the time the label was developed.

Two examples: Taxol (paclitaxel), used to treat ovarian and breast cancer, may in some instances be appropriate in pregnancy even though it causes birth defects in animals and is therefore believed to cause fetal harm in humans. The benefits of its use to fight life-threatening cancers may outweigh the potential harm to a fetus.

Accutane (isotretinoin) should never be used in pregnancy. It is highly effective for treating severe cystic acne, but it causes serious birth defects. There are other drugs available to treat acne, and the disease is not life-threatening to the mother.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.