Thursday 22 March 2018

One in 50 babies has ‘birth defect’ in England and Wales

Photo: Thinkstock
Photo: Thinkstock

Jane Kirby

MORE than one in 50 babies has a birth defect - almost double the previous estimate, according to the most comprehensive report of its kind.

Previous figures have suggested one in 80 babies suffers a defect, which include Down's syndrome, congenital heart disease and neural tube defects such as spina bifida.

The report, from the British Isles Network of Congenital Anomaly Registers (Binocar), covers five registers of defects in England and Wales.

It includes babies born with a defect as well as those babies where the defect led to a termination of the pregnancy.

The researchers estimate there were at least 14,500 babies with birth defects in England and Wales in 2009.

Joan Morris, professor of medical statistics at Queen Mary, University of London and editor of the report, said researchers did not believe the overall incidence of birth defects is on the rise.

"We know that the incidence is not increasing," she said.

"What we are now saying is that we have good figures on what it actually is."

However, she said large parts of the country, including London, do not submit any data, making it difficult to identify whether these regions are experiencing an increase in any types of defect.

The report included data from five regional registers. No registers exist in London and the South East, the North West and East Anglia.

The report said the most common defect is congenital heart disease, which affects at least five in 1,000 babies and can require major surgery.

Around 6pc of babies born with a heart defect will die before the age of one.

Neural tube defects, such as spina bifida, affect one in 1,000 babies. Most of these cases could be prevented through women taking folic acid supplements while trying to conceive and during early pregnancy.

Gastroschisis - a defect where the intestines develop outside the abdomen - affects one in 1,000 babies.

Regional monitoring has shown that this condition has become more common in some areas, including Wales, and that babies born to younger mothers are at greater risk.

Prof Morris said: "Over the last decade, it's doubled in Wales. Your risk is much higher if you are a younger mother."

She said factors such as alcohol, smoking and lifestyle were believed to influence the risk.

According to the report, the estimated incidence of cleft lip and/or palate is 15.2 per 10,000 babies.

Some 27 per 10,000 babies across England and Wales are also affected by Down's syndrome, two per 10,000 by another chromosomal condition called Patau syndrome and seven per 10,000 by Edwards syndrome.

London has the highest prevalence of Down's syndrome (34 per 10,000 babies) while the North West had the lowest (21 per 10,000).

The report said these differences "probably reflect the different maternal age distributions", with mothers in London tending to be older, thereby having a higher risk of Down's.

More than half (53pc) of all birth defects studied in the report were detected during pregnancy.

Where the birth defect was detected in pregnancy, 43pc resulted in a termination.

Of those babies born alive, where the time of diagnosis was known, 68pc were diagnosed at birth, 9pc were diagnosed in the first week, 7pc between the second and fourth weeks and 17pc after the first month.

Prof Morris said the figure on more than one in 50 babies affected by a defect represents England and Wales.

"The one in 50 figure is from the five registries that we covered. It may be a little bit higher (rate across England and Wales) but it's pretty close."

She said cases of spina bifida and other neural tube defects seem to have come down but are still much higher in England and Wales than the rest of Europe.

There is no national data to say whether recommending women take folic acid is working, or whether measures such as fortifying flour would work better, she added.

"(The number of cases of) heart anomalies seems to be coming down," she added.

"People believe it may be something to do with folic acid but that's not been proven.

"We are not really certain. It could be better general health, such as people eating more fruit and vegetables."

Prof Morris added that the overall incidence of Down's syndrome is increasing, reflecting the profile of older mothers.

She said it was essential that better overall data is collected in the future from all parts of England and Wales.

"This is a major issue," she said.

"It is essential we know how many babies are being born with anomalies and how good their survival is across the whole country, so we can identify ways to reduce the occurrence of anomalies and plan for the care of these babies."

The report's authors said a lack of strategic funding coupled with a lack of support at national level has led to the closure of a national system on collecting data and some of the regional registers.

Previous estimates, based on data from the Office for National Statistics, suggested that 1.3% of all babies have a birth defect.

The new report, which covers data from 2005 to 2009, indicates that the figure is more than 2%.

A spokeswoman for the Department of Health said: "Parents who are fit and healthy at the start of pregnancy generally have healthier babies.

"About half of pregnancies in England and Wales are unplanned, which can cause a delay in seeing a health professional.

"Because of the risks, pregnant women or women trying to conceive should try to avoid drinking alcohol and stop smoking, eat a balanced diet and maintain a healthy weight."

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