Global survey of birth defects published

A US charity has published a report on the worldwide incidence of birth defects and genetic conditions. The March of Dimes Global Report on Birth Defects reveals that six per cent of all babies - nearly eight million infants - are born with congenital health problems each year. Over three million of these children die before the age of five, say the authors.

The report gathered information from 193 countries, using national health databases, the World Health Organisation (WHO), the United Nations (UN) and the United Nations Children's Fund (UNICEF). The authors say it is the first time that 'the severe, and previously hidden toll of birth defects' has been identified. 'This is a serious, vastly unappreciated and under-funded public health problem', said Jennifer L Howse, president of the March of Dimes.

The rate of birth defects varies widely, from a high of 82 per 1000 in The Sudan, to 39.7 per 1000 in France. In the US, the figure is 47.8 per 1000, with five common causes of 'genetic or partially genetic origin' accounting for 26 per cent of all congenital problems. These are heart defects, neural tube defects such as spina bifida, blood disorders such as sickle cell disease, Down syndrome and a genetic condition called glucose-6-phosphate dehydrogenase deficiency.

The authors say that many birth defects could be avoided, with interventions such as adding folic acid to flour to prevent neural tube defects, adding iodine to salt to prevent severe congenital hypothyroidism, and giving rubella vaccinations to prevent congenital rubella syndrome.

The report also recommends strengthening medical genetics services in poorer countries, so clinicians can identify couples at higher risk of having children with genetic disorders. As well as a lack of healthcare resources, it also points to higher rates of consanguineous marriages and births to older mothers in these countries as reasons for their higher rates of birth defects. The report also notes that only 50 per cent of birth defects are accurately diagnosed, even in wealthy countries.