Key Research Findings
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Maternal Infections: Infections of the uterus and/or urinary tract – diagnosed or suspected in about 3% of women in labor – increase CP risk 9 times among normal birthweight/full term babies.
Twins: A twin pregnancy is 12 times more likely to result in 1 or both twins having cerebral palsy than a singleton pregnancy. Low birthweight alone does not account for the high prevalence of CP in twins.
Maternal Age, Substance Abuse & SES (Socioeconomic Status): 25% of the babies born with gastroschisis are born to teen mothers. Using recreational drugs before or early in pregnancy increases risk as does having greater social and economic challenges during childhood and young adulthood.
Medications: Mothers who take either aspirin or ibuprofen in the first trimester are 4 times as likely to have babies with gastroschisis. Acetaminophen, the most commonly used medication in pregnancy, does not increase gastroschisis risk.
Work & Hobbies: Mothers exposed to organic solvents have more than double the risk of having babies with gastroschisis. Solvent exposure through hobby related activities poses a greater risk than through work.
Heart and Limb Defects: Mothers taking folic-acid containing multivitamins during the month before conception or the first 2 months of pregnancy have 30% less chance of having babies with conotruncal heart defects, particularly tetralogy of Fallot, and 36% lower risk for longitudinal limb defects.
Neural Tube Defects: Most studies report multivitamins reduce risk for having a baby with a neural tube defect (NTD) by 50% to 70%. California women using vitamins have a 35% lower risk than non-users. Hispanic women, who are at highest risk for having a baby with an NTD, lower their risk only 5% to 25% by using folic acid-containing multivitamins.
Oral Clefts: Mothers taking multivitamins containing folic acid have a 50% risk reduction for having babies with isolated cleft lip with/without cleft palate. Risk for cleft palate alone is lowered 25%.
Neural Tube Defects
Nitrates: Nitrates in food did not increase risk for neural tube defects. Inconsistent effects on anencephaly risk were found for nitrates in drinking water depending on the source of the water.
Obesity: Women who are obese before pregnancy are nearly twice as likely to have fetuses or infants with neural tube defects. Taking vitamins containing folic acid does not mitigate the higher risk associated with obesity and excluding diabetics from the analysis did not alter the findings.
Prenatal Diagnosis–Impact of Rates: Scientists including only live births and fetal deaths in their neural tube defects studies exclude 40% of cases. Women who electively terminate pregnancies have different demographic characteristics than those who deliver liveborn or stillborn infants.
Cost of Birth Defects: This is the most comprehensive study of lifetime costs for 17 common birth defects and cerebral palsy. The combined lifetime cost is estimated at $8 billion in a single year. About 22% of babies born with birth defects will have one of these 18 conditions.
Hazardous Waste Sites: Women who live within 1/4 mile of a Superfund site during the first 3 months of pregnancy may have a greater risk of having a baby with conotruncal heart defects and neural tube defects
Pesticides: 75% of pregnant women are exposed to pesticides through at least 1 source, most commonly in the household. Risks are slightly elevated for household gardening and certain types of oral clefts, neural tube defects, heart defects and limb defects; and for living within 1/4 mile of agricultural crops and neural tube defects.
Smoking and Oral Clefts–Gene/Environment Interaction: Mothers who smoke double their risk for having babies with cleft lip and/or palate. Infants who have a particular form of the gene involved in palate and mouth development are 8 times as like to have oral clefts if their mothers smoke.
Stressful Life Events and Birth Defects: Women who experience at least 1 stressful event, such as divorce, death of someone very close, or job loss, are more likely to have a baby with isolated cleft lip and palate, spinal defects, and certain heart defects.