Chijioke Iremeka
Maternal health experts have stated that infection control during pregnancy reduces the risks of babies being born with birth defects whether structural or functional anomalies.
The gynaecologists said congenital disorders also known as congenital anomalies could be prevented through vaccination, lifestyle modifications, and infection control during pregnancy.
Congenital disorders such as hearing defects, and holes in the heart, they noted are structural anomalies present at birth that could cause physical disability, intellectual and developmental disability, and other health problems.
The physicians said that congenital disorders linked to environmental factors such as maternal exposure to certain medications, chemicals, and alcohol, could be prevented, but genetic triggers, such as mutations, can’t be prevented.
Though not all these disorders can be treated, the experts underscored the importance of parents understanding these triggers to help protect their unborn babies.
According to the World Health Organisation report of February 27, 2023, an estimated 240,000 newborns die worldwide within 28 days of birth each year due to congenital disorders, which also lead to an additional 170,000 deaths among children aged one month to five years.
The global health body highlighted that congenital disorders can contribute to long-term disabilities, imposing a significant burden on individuals, families, healthcare systems, and societies, alarmingly that nine out of 10 children born with a serious congenital disorder are in low-and middle-income countries.
“As neonatal and under-5 mortality rates decline, congenital disorders account for a larger proportion of neonatal and under-5 deaths. The most common severe congenital disorders include heart defects, neural tube defects, and Down syndrome.
“While congenital disorders can arise from a combination of genetic, infectious, nutritional, or environmental factors, pinpointing the exact causes is often challenging,” the WHO added.
Speaking exclusively with PUNCH Healthwise in different interviews, the physicians stressed that preventing congenital disorders involves addressing modifiable risk factors and genetic counselling for those that have a family history of genetic disorders.
They noted that some congenital disorders could be prevented, emphasising that vaccination, adequate intake of folic acid and iodine through the fortification of staple foods or supplementation, and proper care before and during pregnancy are effective prevention methods.
Consultant Obstetrician and Gynaecologist at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Dr Chukwuneme Okpala, said that ensuring adequate prenatal care and monitoring foetal health, were crucial to preventing congenital disorders.
Okpala, who defined congenital disorders as those existing at or before birth, emphasised that promoting a healthy lifestyle before and during pregnancy, such as maintaining a balanced diet, avoiding harmful substances, and managing chronic conditions, can significantly reduce risks.
He highlighted the importance of vaccination in preventing infections that may lead to congenital anomalies, noting that early diagnosis and treatment can greatly improve outcomes and quality of life.
Okpala stated, “Disease prevention is crucial in preventing congenital disorders. Through vaccination, mothers can mitigate several diseases that pose risks to unborn babies.
“Lifestyle modifications can help prevent diabetes, which is known to increase the risk of congenital disorders in unborn infants. Regular check-ups are also vital for monitoring maternal and foetal health, allowing for the early detection of potential issues.
“Management of congenital disorders often requires a multidisciplinary approach, incorporating early intervention services, surgical options, and ongoing medical care tailored to the individual’s specific needs.”
He cautioned against the use of certain drugs, particularly recreational substances, before and during pregnancy, citing their high-risk factors.
While he acknowledged that genetic problems cannot be controlled, he strongly advised managing diabetes, which is one of the most common causes of congenital disorders.
Regarding treatment and management, he noted, “Some congenital disorders are compatible with life, while those that are not will result in death shortly after birth. Screening and monitoring foetal development are essential.
“For cases where survival is unlikely, doctors will make informed decisions. In some countries, laws permit the termination of high-risk pregnancies on medical and social grounds, but this practice is not common in Nigeria.
“Certain congenital conditions can be corrected, depending on their nature. For instance, a child born without a brain will not survive after birth, while others may be born without limbs. Ultimately, many of these conditions can be prevented or managed through modifiable lifestyle choices.”
Speaking on prevention, another Consultant Gynaecologist and Obstetrician at Epe General Hospital in Lagos, Dr. Cynthia Okafor, emphasised that ensuring adolescent girls and mothers maintain healthy diets can significantly reduce the risk of these conditions in the country.
She highlighted the importance of consuming a variety of vegetables and fruits, as well as maintaining a healthy weight, to lower the risk of congenital disorders and promote a better quality of life for children.
Okafor stressed the need for adequate dietary intake of vitamins and minerals, particularly folic acid, among adolescent girls and mothers.
She advised that mothers should avoid harmful substances, especially alcohol, tobacco, and recreational drugs.
“Reducing environmental exposure to hazardous substances, such as heavy metals and pesticides, during pregnancy is crucial. Administering insulin to diabetic patients who need it can be very helpful.
“Vaccination is one of the most important and cost-effective ways to prevent various childhood diseases. Therefore, vaccinating against illnesses such as the rubella virus is highly recommended for women planning to conceive.
“We also need to enhance awareness and education among health workers and others involved in promoting the prevention of congenital disorders. Screening for infections, particularly syphilis, and treating them when necessary is essential.”
According to her, some congenital disorders can be treated with medical or surgical interventions, although access to such care may vary by country and across different levels of healthcare systems.
She noted that surgery, coupled with good follow-up care, can often mitigate the potential lethality associated with congenital heart defects or reduce morbidity linked to structural congenital disorders.
“Outcomes improve with early detection at lower levels of the healthcare system through screening, referral, and management at specialised centres, particularly for issues like cardiac defects,” she explained.
Okafor added that children with certain types of congenital disorders may require long-term support, including physical therapy, speech therapy, occupational therapy, and assistance from families and the community.
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