Birth defects

Abnormalities that are obvious at birth or detectable early in infancy. Also called congenital defects, they encompass both minor abnormalities, such as birthmarks, and serious disorders such as spina bifida. Causes include chromosomal abnormalities, genetic defects, drugs taken during pregnancy, exposure to radiation, and infections. In some cases, the cause of a defect is unknown. Defects that are due to chromosomal abnormalities include Down’s syndrome. Some defects, such as achondroplasia and albinism, are usually inherited from 1 or both parents (see gene; genetic disorders). Certain drugs and chemicals (called teratogens) can damage the fetus if the mother takes or is exposed to them during early pregnancy. Teratogenic drugs include thalidomide (now rarely prescribed) and isotretinoin, which is used in the treatment of severe acne. Alcohol can affect the development of the brain and face (see fetal alcohol syndrome). Irradiation of the embryo in early pregnancy can cause abnormalities. Very small doses of radiation increase the child’s risk of developing leukaemia later in life (see radiation hazards). Certain illnesses, such as rubella (German measles) and toxoplasmosis, can cause birth defects if they are contracted during pregnancy. Brain and spinal cord abnormalities, such as spina bifida and hydrocephalus, and congenital heart disorders (see heart disease, congenital) result from interference with the development of particular groups of cells. Other common defects include cleft lip and palate. Ultrasound scanning and blood tests during pregnancy can identify women at high risk of having a baby with a birth defect. Further tests such as chorionic villus sampling, amniocentesis, or fetoscopy may then be carried out.