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PCHHC Newsletter
January 2015
Preconception Health & Birth Defects Prevention   

Every 4 minutes, a baby is born with a birth defect in the U.S. That translates into nearly 120,000 babies affected by birth defects each year. While this number constitutes a relatively small proportion of all babies born in this country each year(about 3%), birth defects account for more than 20% of all infant deaths.


Birth defects can occur during any stage of pregnancy, and are identifiable prenatally, at the time of birth, or any time postpartum. Most birth defects occur within the first 3 months of pregnancy, when the organs of the fetus are forming. However, some birth defects occur later in pregnancy as the tissues and organs continue to grow and develop during the last six months of pregnancy.


Most birth defects are thought to be caused by a complex mix of factors. These factors include genetics, health behaviors, and environmental exposures. For some birth defects the cause is known, but for most, the causes have yet to be identified. Certain risk factors increase the chance that a pregnancy will be affected by a birth defect. Some of these include:

  • Using tobacco, drinking alcohol, or partaking in recreational drug use before and during pregnancy.
  • Having certain medical conditions, such as obesity or uncontrolled diabetes before and during pregnancy.
  • Taking certain medications, such as isotretinoin (a drug used to treat severe acne).
  • Having a family history of birth defects.
  • Having inadequate amounts of folate.
  • Being an older mother, typically over the age of 34 years.

Having one or more of these risks does not mean a pregnancy will be absolutely affected by a birth defect. Also, women can have a baby born with a birth defect even when they don't have any of these risks. It is important that women talk to their health care providers before pregnancy to determine what they can do to lower their risk. Given that birth defects occur early in pregnancy, preconception health is essential for reducing risks.  


Recognizing Young Children Living with Birth Defects 

By: Coleen A. Boyle, PhD, MSHyg

Director, National Center on Birth Defects and Developmental Disabilities (NCBDDD) at the CDC


Did you know that birth defects affect one in every 33 babies born in the United States? Those aren't just numbers-they represent real babies and families.


Elley was born with spina bifida, a birth defect of the spinal cord. She relies on a wheelchair to move around. Her mom, Maryanne, says, "Yes, heads turn when a wheelchair rolls into a room, but she uses that attention to force people to talk to her. She is a social butterfly!"


Elley's family encourages her to do everything that anyone her age can do. Maryanne says, "We have to make alterations here and there to maneuver her around, but we try to treat her as normal as possible and not make her feel as if she is a burden in any way! We take family vacations and get her out of the house as much as possible. She loves to go to church, and we try to include her in all the activities with her age group She is extremely brave and although she has times of anxiety about the unknowns that may be facing her, she presses on with a courageous heart."


January is National Birth Defects Prevention Month. According to the Centers for Disease Control and Prevention (CDC), babies with birth defects who survive their first year of life can have lifelong challenges, such as problems with physical movement, learning, and speech. We know that early intervention is vital to improving the health for these babies.


Elley's story underscores CDC's National Center on Birth Defects and Developmental Disabilities (NCBDDD)'s work to identify causes of birth defects, find opportunities to prevent them, and improve the health of those living with birth defects. NCBDDD's mission is to promote the health of babies, children, and adults and enhance their potential for full, productive living.


Take a moment to learn more about how you can support a child and family living with a birth defect as well as steps that you can take to prevent birth defects if you are thinking of getting pregnant in the near future. Visit 

National Birth Defects Prevention Month Resources  
Please join the CDC's National Center on Birth Defects and Developmental Disabilities (NCBDDD) in recognizing January as National Birth Defects Prevention Month! The theme this year is "Making Healthy Choices to Prevent Birth Defects: Make a PACT for Prevention." Although not all birth defects can be prevented, actions can be taken to increase a woman's chance of having a healthy baby. This year we are encouraging all pregnant women and those who may become pregnant to:
  • Plan ahead
  • Avoid harmful substances
  • Choose a healthy lifestyle
  • Talk to your healthcare provider
In January, NCBDDD will be promoting birth defects prevention through a variety of activities.
Special Web Features
A series of web features will be posted on the CDC website this month.  The first one, in honor of Folic Acid Awareness Week, highlights the importance of consuming 400 micrograms of folic acid daily before and during pregnancy to reduce the risk of neural tube defects. Check back each week to see new features on making a PACT for birth defects prevention.
National Birth Defects Prevention Month Tweet-up & Social Media Buttons
During the month of January, NCBDDD will be sharing a fact each day on Twitter to raise awareness of birth defects. Each fact will be marked by the hashtag: #1in33. We encourage you to participate by following, re-tweeting, and tweeting your own facts! In addition, NCBDD has created buttons of various sizes for you to post to your website, blog, or social networking site.
Morbidity and Mortality Weekly Report (MMWR) Articles
Be on the lookout for new articles in upcoming issues of CDC's Morbidity and Mortality Weekly Report. Check CDC's site each week this month for new birth defects-related research findings.
CDC Public Health Grand Rounds
To learn more about birth defects research, we invite you to join us at 1PM EST on January 20, 2015 for CDC's live webcast titled "Understanding the Causes of Major Birth Defects: Steps to Prevention." Experts in birth defects research will present an overview of current and historical efforts to understand the causes of major birth defects. They will also discuss the challenges in turning research findings into effective prevention. For more information on the upcoming session, click here. 
Inaugural Launch of State Data on Major Birth Defects
The March of Dimes' PeriStats website provides easy, free access to National Birth Defects Prevention Network data on major birth defects by state
New Birth Defects Prevention E-cards
CDC has more than 100 free Health-e-Cards (or "electronic greeting cards") to send to friends, family, and co-workers. Simply select a new birth defects prevention e-card, type in an email address and name, and send a message about birth defects prevention.
National Birth Defects Prevention Network Educational & Promotional Materials
The National Birth Defects Prevention Network has educational and promotional materials available via their website. Feel free to use these materials to promote birth defects awareness and prevention. 
What You Can Do
Spread the word! We encourage you to share these links with your colleagues and friends.  Become an active participant in National Birth Defects Prevention Month. Join us in a nationwide effort to raise awareness of birth defects, their causes and their impact.
Mark Your Calendars! 
Please save the date for the second portion of a two-part webinar series on preconception health and chronic disease prevention and management:
Wed, 2/18 at 1pm EST

The first part of this series will be available to view at in the news section by 1/16.

Before Your Pregnancy: A 90-Day Guide for Couples on How to Prepare for a Healthy Conception 

by Amy Ogle & Lisa Mazzullo

Covering preconception and interconception well-being for women and men, Ogle and Mazzullo draw on new research from their complementary fields of expertise and reveal how good preconception health can lower the risk of pregnancy complications and improve lifelong health.


FDA Pregnancy & Lactation Labeling Final Rule (PLLR) 

Effective June 30, 2015, the FDA is requiring changes to the content and format of  prescription drug labeling to assist health care providers when assessing benefit versus risk and counseling pregnant and lactating women and women and men of reproductive age who need to take medication. The PLLR removes the pregnancy letter categories - A, B, C, D and X - and requires the label to be updated when information becomes outdated. Required labeling will now include three sections: Pregnancy, Lactation, and Females and Males of Reproductive Potential.  This new section will provide information on the need for pregnancy testing, contraception recommendations, and information about infertility as it relates to the drug.  New drugs approved after June 30th will have the new label; labeling for previously approved drugs will be phased in gradually. 


Preventable health and cost burden of adverse birth outcomes associated with pregestational diabetes in the United States
Preconception care for women with diabetes can reduce the occurrence of adverse birth outcomes. Authors in this study aimed to estimate the preconception care-preventable health and cost burden of adverse birth outcomes associated with diagnosed and undiagnosed pregestational diabetes mellitus in the United States.
There is general acceptance that folate aids in the prevention of neural tube defects. There is increasing evidence that folate supplementation can prevent or reduce the risk and severity of congenital heart disease (CHD) induced by an abnormal uterine micro-environment. In this study, authors provide a rationale for attempting prevention of CHDs.

Sign Up for Bi-Weekly Preconception Updates to Your In-Box 

To receive a bi-weekly media and literature update on preconception and interconception health through a listserv, please email Cheryl Robbins.
About the Newsletter  
Thanks for reading!  Is your organization doing exciting work to promote preconception health? We would love to feature you in an upcoming newsletter.  Email us for details, or if you have any questions about the newsletter.       
Do you work on issues related to preconception health and birth defects? 
Please email us - we would love to know more about your work and to connect you with the PCHHC Initiative. 
This e-newsletter is archived.  Find back issues of the newsletter and more information about improving preconception health and health care here.