Tackling the invisible threat of birth defects

Rumbidzayi Zinyuke

Health Buzz

Every day around 362 000 babies are born around the world.

For most mothers, this is a joyous occasion. But for an estimated one in 33 of these mothers, their joy is overshadowed by the news that their new-born baby has a birth defect.

Birth defects or congenital anomalies are a serious global health challenge, causing death or lifelong difficulties for millions of children each year.

In Zimbabwe, the situation is no different.

While data on the exact prevalence of birth defects is lacking, there is a significant number of children born with these conditions every year.

Many of these cases go unreported due to cultural beliefs, traditions, and limited access to healthcare.

Birth defects are responsible for the death of an estimated 295 000 new-borns each year during the first 28 days of life.

For those who survive, they can cause lifelong physical and psychological difficulties and have profound physical, emotional and economic consequences for families.

According to experts, congenital anomalies can affect various parts of the body, including the heart, brain or limbs. The spectrum of birth defects is vast, ranging from minor anomalies like extra fingers to severe conditions impacting major organs.

These defects are caused by various issues including inherited genetic mutations or chromosomal abnormalities, environmental factors such as exposure to certain infections (like rubella), harmful substances (like alcohol and certain medications), and environmental toxins.

 They can also be caused by nutritional deficiencies while pre-existing medical conditions in the mother, such as diabetes or autoimmune diseases, can also increase the risk.

The common conditions include Spina Bifida, a neural tube defect where the spinal cord fails to develop properly, cleft lip and palate, heart defects and Down Syndrome among many others.

Heart defects are the most common congenital anomalies. Most have no obvious cause, but if a pregnant woman has diabetes or smokes during pregnancy, it may increase the chance.

There are many different types of heart defects, depending on the affected area of the heart.

These can range from simple conditions that do not cause symptoms to complex problems that cause severe, life-threatening symptoms if left untreated.

At least 4 500 children are born with a congenital heart disease each year in Zimbabwe and are in need of open heart surgery. However, some succumb to the natural disease progression as the disease is often left untreated due to the high cost of having the surgery outside the country.

 Zimbabwe is expected to launch a sustainable paediatric open heart surgery programme this year, following the success of a joint congenital open heart surgery camp with Egyptian specialists late last year.

Cleft lip and palate are the most common congenital craniofacial conditions worldwide. In Africa, it is estimated that one out of 700 babies are born with a cleft.

However, the conditions are often left untreated due to barriers such as cost, lack of access to trained medical professionals and social stigma. Without timely intervention, children with cleft lip and palate face lifelong difficulties with eating, speaking, breathing, and mental health. The condition can be corrected with surgery.

Other congenital defects include Down Syndrome where a baby is born with an extra chromosome, which affects brain and body development as well as foetal alcohol spectrum disorders which can occur if a woman drinks alcohol during pregnancy. Cerebral palsy, muscular dystrophy, visual, hearing and language impairments are also common.

As the month of January unfolds, the world observes World Birth Defects Prevention Month, a time to raise awareness about the causes, impact, and prevention of birth defects.

This is an opportune time to highlight these common but debilitating conditions that many think are irreversible.

But with the right interventions, many of these birth defects are preventable and treatable if proactive measures are taken to significantly reduce the risk.

According to the World Health Organisation, of vital importance for birth defect prevention and control is ensuring access for all expectant mothers to high-quality, cost-effective pre-conception and antenatal services.

These services will ensure that women are counselled to meet their nutritional needs before and during their pregnancy, at the same time as avoiding tobacco and alcohol use. They will also help detect birth defects early and manage defect-related complications.

Progress is being made.

Zimbabwe on its part has increased Antenatal care (ANC) coverage over the years although there has been a decline since the advent of Covid-19.

Antenatal care from a skilled provider is important to monitor pregnancy and reduce morbidity and mortality risks for the mother and child during pregnancy, at delivery, and during the postnatal period.

According to the National Demographic Health Survey results, nearly three out of four women aged 15-49 had four or more ANC visits during their most recent pregnancy.

The country, along with others in the African region is improving birth defect surveillance to better understand occurrence and distribution.

WHO believes that through the development of a population-based surveillance programmes that accurately capture congenital anomalies, countries can better understand the burden of these conditions, become more aware of the risks involved, refer identified infants to services in a timely manner, and use prevalence estimates to evaluate and strengthen any current prevention or clinical management programmes.

Countries can also use the information gathered to inform stakeholders and policy-makers about the importance of investing in programmes aimed at reducing the occurrence of congenital anomalies, and to help them plan for appropriate services.

Efforts to increase vaccination for women of childbearing age against conditions that predisposes babies to congenital defects, such as rubella, are also underway.

While Governments play their part in response to this silent tragedy, it is also important to understand that mothers also have a role in ensuring the health of their babies by adopting healthy lifestyles.

This includes avoiding alcohol, tobacco, and illicit drugs during pregnancy. Maintaining a balanced diet and addressing any nutritional deficiencies is also essential.

Above all, raising awareness about birth defects is paramount.

Birth Defects Awareness Month is here to raise awareness about these issues and also work toward better care, highlighting the efforts that can help with prevention.

By educating the public about risk factors, prevention strategies, and the importance of early intervention, communities are empowered to make informed choices and improve the health and well-being of future generations.

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