Public Health Grand Rounds: Birth Defects Prevention

Welcome and Introduction

• Dr. John Iskander welcomes attendees on behalf of CDC.
• Continuing education credits available for health professionals.
• National Birth Defects Prevention Month: Theme is making healthy choices for prevention.
• Partnership with CDC Public Health Library and Information Center for relevant scientific articles.

Keynote by Dr. Ileana Arias

• Birth Defects Statistics: 1 in 33 babies in the US are born with a birth defect (~120,000 annually).
• Importance of Early Pregnancy: Most defects develop early; prevention steps are crucial before pregnancy.
• Actions for prevention:
  • Quitting smoking.
  • Taking folate supplements.
• Environmental exposures and medications as risk factors.

Presentation by Dr. Marcia Feldkamp

• Types of Birth Defects:
  • Functional defects (e.g., cerebral palsy, PKU, sickle cell).
  • Structural defects (major and minor malformations).
• Major Malformations: Occur in 3% of births; congenital heart defects are the most common.
• Cost and Mortality: Birth defects are the leading cause of infant mortality.
• Research and Monitoring: Majority of birth defects have unknown causes; focus on environmental exposures.

Presentation by Dr. Yanita Rafehouse

• CDC-Funded Case Control Studies:
  • National Birth Defects Prevention Study (NBDPS).
  • Association of pre-gestational diabetes with birth defects.
• Treating for Two initiative: Focuses on medication risks during pregnancy.
• New Study - BD Steps: Focus on severe birth defects, maternal diseases, and medication use.

Presentation by Dr. Alan Mitchell

• VAMPS (Vaccines and Medications in Pregnancy Surveillance System):
  • Focus on monitoring vaccine and medication safety in pregnancy.
  • Collaboration with various health organizations.
• Pandemic H1N1 Response: No increased birth defects risk found.
• Need for Continuous Monitoring: Vaccines and medications need ongoing safety evaluations.

Presentation by Suzanne Gilboa

• Folic Acid Success Story: Prevents neural tube defects, saving $4.7 billion.
• Modeling Studies:
  • Impact of maternal obesity, diabetes, and smoking on birth defects.
  • Estimated preventable cases through risk factor elimination.

Q&A Highlights

• Gastroschisis in Young Women: Investigations into causes like infection and risky behaviors.
• Industrial Solvent TCE: Research into environmental and occupational exposures.
• Neural Tube Defects and Folic Acid: Challenges in early pregnancy supplement intake.
• Impact of Maternal Age and Pre-Conception Health: Research needed on age-related risks and preconception care.
• Men's Role in Prevention: Encouraged to plan pregnancies and manage occupational exposures.
• Obesity in Reproductive Life Plans: Importance of healthy weight before pregnancy, ongoing research into impacts.

Conclusion

• Birth Defects are Common, Costly, and Critical: Need for ongoing research and prevention efforts.
• Next Session: Update on Global Polio Eradication Initiative.