All about giving birth to happy, healthy baby

A happy, healthy child is everybody's dream. Ever since a woman gets conceived, her fantasy about her offspring takes wings. And she experiences bliss until the bundle of joy comes out to the outer world from her womb. The rest is - joy and happiness in abundance.

But unfortunately, millions of babies are born with birth defects every year across the globe, shattering dreams and pushing parents into despair.

These birth defects are structural changes present at birth that can affect almost any part or parts of the body (e.g., heart, brain, foot). They may affect how the body looks, works, or both. Birth defects can vary from mild to severe. The well-being of each child affected with a birth defect depends mostly on which organ or body part is involved and how much it is affected. Depending on the severity of the defect and what body part is affected, the expected lifespan of a person with a birth defect may or may not be affected. Birth defects in four percent to seven percent of infants show one or more significant defects at birth. A birth defect can be visibly obvious, an internal defect, or a chemical imbalance within the body.

The developing baby goes through two major stages of development after conception. The first, or embryo stage, occurs during the first 10 weeks after conception. Most of the major body systems and organs form during this time. The second, or fetal stage, is the remainder of the pregnancy. This fetal period is a time of growth of the organs and of the fetus in general. The developing baby is most vulnerable to injury during the embryo stage when organs are developing. Indeed, infections, radiation, and drugs cause most of their damage when exposure occurs two to 10 weeks after conception. However, some birth defects like damage to fetal brain leading to cerebral palsy due to lack of oxygen can occur later in pregnancy. During the last six months of pregnancy, the tissues and organs continue to grow and develop.

Not all birth defects are detectable at birth. Some, such as sickle cell anaemia (a defect in red blood cells that causes severe anaemia and bone pain) might not become apparent until the child is several months old. A malformed kidney might take years to be discovered.

Birth defects can be caused by genetic factors and by a variety of environmental injuries such as infection, radiation, and drug exposure during pregnancy and autoimmune diseases. The majority of birth defects, however, are multifactorial without detectable cause.

About 50 percent of birth defects are caused by genetic or hereditary factors. Every human body cell contains 46 chromosomes, and each chromosome contains thousands of genes. Each gene contains a blueprint that controls development or function of a particular body part. People who have either too many or too few chromosomes will therefore receive a scrambled message regarding body development and function.

Down Syndrome is an example of a condition caused by too many chromosomes. Because of an accident during cell division, individuals with Down Syndrome have an extra copy of a particular chromosome. This extra chromosome leads to mental retardation, muscle weakness, downward slant of the eyes, low-set and malformed ears, an abnormal crease in defects of the heart and intestines.

With Turner Syndrome, a disorder that is only women, a person lacks a particular chromosome. In the affected persons, this causes short stature, learning disabilities, and absence of ovaries.

Since each of the genes on the chromosomes controls the structure and function of a body part, people with defective genes will show defects in the corresponding body part. These abnormal genes often cause hereditary disorders that pass down within a family. Hemophilia (absence of a blood-clotting chemical) is a familial disorder caused by a defective gene. Other examples of familial gene disorders are cystic fibrosis (a disorder that causes progressive damage of the lungs and pancreas) and sickle cell anaemia.

Defective genes can also be caused by accidental damage, a condition called spontaneous mutation. Most cases of achondroplasia (a condition that causes extreme short stature and malformed bones) are caused by new damage to the controlling gene.

Many birth defects occur in the very early weeks of pregnancy before a woman has missed her first menstrual period, so it is important that she sees her doctor to discuss medical and family history before she conceives. This is especially important for women who have had a previous child with birth defects. Inter-conception care provides a unique opportunity to address specific risk factors that may have contributed to previous poor pregnancy outcomes.

If a woman has enough folic acid in her body before and during pregnancy, it can help prevent major birth defects of her baby's brain and spine. These birth defects are called neural tube defects or NTDs. Research shows that if all women of childbearing age consumed the recommended amount of folic acid, 70 percent of NTDs could be prevented.

Consumption of alcohol, drugs and tobacco can cause birth defects. Ideally, a woman should stop using these substances before she becomes pregnant, but it is never too late to quit.

Germs that cause only mild or no symptoms at all in adults can be deadly to the unborn fetus. Women of childbearing age can avoid some of these by making sure that all of their immunisations are up-to-date before becoming pregnant. Other harmful germs and parasites can be avoided by using good hygiene.

Some medications are shown to be harmful to the unborn fetus. Others are necessary for a mother to remain healthy. In order to find out what medications you should and should not be taking, talk to your physician. Do not start or stop taking new medications (including over the counter and herbal remedies) without first talking with your physician.

Women who have conditions like diabetes, epilepsy, or obesity should talk to their health care provider about measures to take if they are considering pregnancy, or if they discover that they are pregnant. Sometimes better medication or a different dosage is recommended for treating the condition in pregnancy.

Getting enough folic acid and eating well balanced and nutritional meals provides a developing baby with the nutritional needs they need to grow properly.

Generally, women who are obese before pregnancy are at a higher risk for complications during their pregnancy. Additionally, the risk for some serious birth defects is increased in women who are obese. Talk with a doctor about ways to reach and maintain a healthy weight before and during your pregnancy.

Because most substances can pass through the placenta into the fetus' blood supply, mothers-to-be should avoid exposure to anything toxic. This includes fumes from strong household chemicals such as gasoline, paints, paint thinner, and pesticides; lead in some paints; and water from contaminated sources.

Even though you may feel healthy, it is important to see your doctor regularly. Doing this can help catch any complications early on. Certain women are at higher risk than others if they have already had a baby with a birth defect. Getting proper care can address any risk factors that may have contributed to poor pregnancy outcomes from a previous pregnancy.

(The writer is consultant in fetal medicine at the Institute of Genetics and Hospital for Genetic Diseases, Osmania University)