Birth Defects

Sixty million American women of childbearing age are at risk for having a baby with easily preventable birth defects.Many women want to have babies, but for some it happens sooner than they expect. In the United States, half of all pregnancies are unplanned, and one of every 20 girls becomes pregnant the first time she has sexual intercourse.Within 28 days of conception, before a woman has missed her menstrual period, the baby's brain and spinal column are completely formed. It's already too late to take the simple nutritional steps that will prevent two serious birth defects -- known as neural tube defects -- that happen to one of every 1,000 infants born in the United States.

Each year in Maryland, approximately 75,000 women unintentionally become pregnant. Of those pregnancies, about 36,000 end in abortions and 8,000 end in miscarriages. Additionally, many unintended pregnancies lead to premature births, low birthweight babies and poor maternal health outcomes. Almost all of these unintended pregnancies are preventable with modern contraception, which should be readily available for every American. We, as medical students at the Johns Hopkins University School of Medicine, strongly disagree with any employer - religious or otherwise - that would refuse to provide full insurance coverage, including contraception, for its employees.

Use of antidepressants by pregnant women doesn't significantly increase the risk of birth defects, with rare exceptions, two studies found. The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine. As many as one in five pregnant women has symptoms of depression, according to the American Pregnancy Association, a Texas-based nonprofit organization.

Study: Ginger capsules ease chemotherapy nausea Ginger, long used as a folk remedy for soothing stomach aches, helped tame one of the most dreaded side effects of cancer treatment - nausea from chemotherapy, the first large study to test the herb for this has found. People who started taking ginger capsules several days before a chemo infusion had fewer and less-severe bouts of nausea afterward than others who were given dummy capsules, the federally funded study found. "We were slightly beside ourselves" to see how much it helped, said study leader Julie Ryan of the University of Rochester in New York.

Intensive management of diabetes in women before they conceive may substantially reduce their risk of bearing children with birth defects, researchers reported today.Infants of diabetic women who began treatment before they became pregnant had significantly fewer abnormalities, according to the results of a study published in this week's Journal of the American Medical Association.The findings were based on a study of 84 diabetic women who began intensive diabetes treatment before pregnancy and another group of 110 who were six to 30 weeks pregnant before treatment began.

Q: What is a hare lip and what can be done about it? We were told a cousin's baby was born with one, and we're embarrassed to ask.A: You have probably heard the term "cleft lip" used for this mild birth defect. Early in development, the upper lip and roof of the mouth are formed when tissue growing in from each side of the face meets tissue growing down from the nose. If the parts don't grow together properly, there will be an indentation or defect in the upper lip. Sometimes the defect continues all the way up into the nostril and even involves the roof of the mouth (cleft palate)

WASHINGTON -- The Supreme Court raised the prospect yesterday that families with children born with deformed arms, legs, hands and feet may have a chance -- after years of frustration in the courts -- to prove that a major drug company's product was to blame.In a unanimous ruling, the court opened the federal courts to hear more scientists and doctors give their opinions about how birth defects, diseases or injuries were caused -- perhaps linking them to such things as medicines, surgery, industrial chemicals and faulty products.

WASHINGTON -- The Supreme Court moved yesterday into the midst of the long legal battle over a pregnancy drug, no longer in use, that some experts claim was a cause of birth defects in many children.By taking on a significant new case about the morning-sickness drug Bendectin in a brief order, the court also put itself in a position to rule on one of the Bush administration's election-year complaints against lawyers.That complaint, repeated often by Vice President Dan Quayle, is that lawyers use "junk science" to try to sway juries to bring in verdicts against drug companies and other manufacturers of consumer products.

MATAMOROS, Mexico -- On one side of Ernestina Sanchez de Martinez's street is the Retzloff pesticide plant, emitting pungent fumes in which her children play. A chemical leak in 1983 forced authorities to empty the area, destroy pets and bury wash hanging on clothes lines.On the other side of Mrs. Sanchez's street is the U.S.-owned Stepan plant, which makes foaming agents for shampoos. The plant has a history of illegally dumping waste. Last summer, a few days after neighbors were given a goodwill tour, a mixing tank exploded, shattering windows and confidence.

SACRAMENTO -- California officials reversed themselves yesterday, warning that the chemical that spilled into the Sacramento River three weeks ago near Dunsmuir may cause birth defects and urging pregnant women in the area to seek testing.The announcement, which came two weeks after officials said that there was no evidence that metam sodium could cause birth defects, stems from a review of data stored in secret files at the California Department of Food and Agriculture for several years, officials said.

Use of antidepressants by pregnant women doesn't significantly increase the risk of birth defects, with rare exceptions, two studies found. The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine. As many as one in five pregnant women has symptoms of depression, according to the American Pregnancy Association, a Texas-based nonprofit organization.

Water sloshed back and forth in a tinted fish tank as Elim Hong carried it into a lab at the University of Maryland, Baltimore County. The graduate student collected zebrafish embryos from the bottom of the tank and placed them in small dishes. She handed them off to Rachel Brewster, who slid them under a microscope. "The mutated embryos have an inflated ventricle," said Brewster, an assistant professor of biological sciences at UMBC, as she peered into the microscope. "And you can see numerous cells that are detached from the walls of the neural tube and are populating space."

Every year, about 450 children are born with serious birth defects in Maryland, and that number is rising. A proposal approved by the House of Delegates last week could help reduce these instances by requiring the state Department of Health and Mental Hygiene to provide low-income women with free multivitamins and mineral dietary supplements that contain folic acid, a B vitamin that significantly reduces birth defects. The legislation is good public policy that could also save the state millions in subsidized health care costs.

On the wall of Chris Crowe's bedroom is a poster of former major league pitcher Jim Abbott, with a quote that reads, "I work very hard and I felt that I could play the game and the only thing that could stop me was myself." For Crowe, a junior reserve outfielder for Havre de Grace, Abbott's words are an inspiration. Abbott was born without a right hand and went on to have a 10-year career in the majors. Similar to Abbott, Crowe only has full use of one arm due to a birth defect. Though Crowe has both hands, he has very limited use of his left hand, which is about a third of the size of his right.

Nearly 8 million children each year are born with birth defects that are genetic in origin, and fully 70 percent of them could be prevented or mitigated, according to the first worldwide study commissioned by the March of Dimes. In the absence of treatment, at least 3.3 million of the children die before the age of 5, while 3.2 million are disabled for life, according to the study released yesterday. "Our report identifies for the first time the severe and previously hidden global toll of birth defects," said Dr. Jennifer L. Howse, president of the March of Dimes.

WASHINGTON - Federal regulators unveiled yesterday a high-tech system to restrict distribution of Accutane, a drug that has been effective against severe acne but has long been known to cause birth defects and is being studied for a possible connection to teen suicides. Patients, doctors, pharmacists, wholesalers and manufacturers all will be required by the Food and Drug Administration to enroll and participate in an Internet-based tracking system primarily designed to ensure that women don't get pregnant while taking Accutane.

Women in the first month of pregnancy should stay away from hot tubs and spas to protect their fetuses from developing birth defects, physicians warn.Women who are exposed to such heat sources early in pregnancy have two to three times the normal risk of having a child with spina bifida or other neural tube defects, according to a report in today's s Journal of the American Medical Association. The finding appears to confirm earlier but unsubstantiated reports and anecdotal evidence.In addition to using a hot tub, if the mother-to-be also runs a fever caused by an infection during the first month, the total risk can be as much as six times higher than normal, according to results of the largest study of birth defects so far undertaken.

Q. I have been on Accutane to treat bad acne for almost a month. I have taken 26 tablets, but stopped taking it when I thought I might be pregnant. I found out yesterday that I am indeed pregnant, and I am scared. I want to have this baby, but after reading about Accutane causing birth defects, I am not so sure. What should I do? A. We were shocked to learn that you have become pregnant while taking Accutane. This acne medicine related to vitamin A can cause very serious birth defects in a fetus.

CHICAGO - You might be a redneck, says Jeff Foxworthy, if you go to your family reunion to meet women. That's the sort of attitude faced by Eleanor Amrhein and Donald Andrews, first cousins who fell in love and decided to get married. When Mr. Andrews proposed, he asked his beloved, "Are you prepared to go through the hell we're going to go through?" He knew what he was talking about. When the two started living together, they told The Washington Post, Ms. Amrhein's parents severed relations with her and friends accused them of defying rules set down in the Bible.

One of the stars of the biological research world is a millimeter long and probably lives in your back yard. Caenorhabditis elegans, a worm with no heart, bones or blood, has been used by one group of scientists to win a Nobel Prize and by others to explore how life works. The growing army of researchers who work with C. elegans appreciate it for practical and scientific reasons. Most important, the tiny creatures have something in common with humans. C. elegans became the first multicellular organism to have its genome sequenced in 1998.