Birth Defects: Answers to Your 13 Most-Asked Questions

7. What causes birth defects?
We do not know what causes most birth defects. Sometimes they just happen and are not caused by anything that the parents did or didn't do. Many parents feel guilty if they have a child with a birth defect even if they did everything they could to have a healthy child. If you have a child with a birth defect, it might be helpful to talk with other parents who have had a child with the same condition. Sometimes the causes of birth defects are figured out after the baby is born. Whenever possible, it is important to know what you can do for a better chance of having a healthy child in the future. Some actions might increase the chances of having a baby with a birth defect. The questions and answers that follow talk about some of these known risks.

8. Do prescription drugs cause birth defects?
Some prescription drugs cause birth defects and should never be taken if there is any chance that a woman is pregnant or could become pregnant while taking the drug. Drugs that are used to treat a serious or life threatening illness should be avoided if possible. Prescription drugs known to cause birth defects include thalidomide (Thalomid) and isotretinoin (Accutane). A pregnant woman should always talk with her doctor about the risks and benefits of any drugs before taking them. Even a woman who is not pregnant now but who might get pregnant while she is taking these drugs should talk with her doctor. It is very important to use two reliable forms of birth control if you are taking these drugs.

There are a few drugs that do not have any link with birth defects when taken by a pregnant woman. We say those drugs have little risk. Most drugs are between the two extremes of having great risk and little risk. Also, there are no studies of how most drugs affect pregnant women. As a result, we do not know if it is safe for a pregnant woman to take these drugs. Women who could get pregnant should talk with their doctor about any drugs they are taking. Together, they can decide if the benefit of the drug is worth the possible risk. If a woman finds out that she is pregnant while she is taking a drug, she should talk to her doctor soon. Some drugs are needed to keep the mother healthy. Not taking some drugs while she is pregnant may put both the woman's and her baby's health in danger. It is important for the woman and her doctor to talk about any drug she might need to take. The doctor can consider the woman's full medical history.

9. Does alcohol cause birth defects?
Fetal alcohol syndrome (FAS) is one of the leading known causes of mental retardation and birth defects. If a woman drinks alcohol during her pregnancy, her baby can be born with FAS, a lifelong, physically and mentally disabling condition. FAS is characterized by (1) abnormal facial features, (2) growth deficiencies and (3) central nervous system (CNS) problems. Individuals with FAS may have problems with learning, memory, attention span, problem solving, speech and hearing. These problems often lead to difficulties in school and problems getting along with others. FAS is an irreversible condition that affects every aspect of an individual's life and the lives of his or her family. However, FAS is 100 percent preventable -- if a woman does not drink alcohol while she is pregnant.

Alcohol in the mother's blood crosses the placenta freely and enters the embryo or fetus through the umbilical cord. The exact mechanism(s) by which alcohol damages the fetus and critical times of exposure are not known; however, exposure during the first trimester results in the structural defects (i.e., facial changes) characteristic of FAS, whereas the growth and CNS disturbances could occur from alcohol use during any time in pregnancy.

The U.S. Public Health Service has indicated that there is no safe level of alcohol use during pregnancy. If a woman drinks while pregnant, she puts her developing fetus at risk for a wide spectrum of adverse effects including spontaneous abortion; growth retardation; physical, mental, and behavioral abnormalities; facial abnormalities; and CNS impairment, such as developmental delay, speech or language delay, lower IQ and decreased head circumference. In the worst cases, prenatal exposure to alcohol may result in fetal death.

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