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Huge rise in babies born with defects

Experts fear pollution and drug use may be causing abnormalities

Jeremy Laurance
Monday 18 March 2002 01:00 GMT
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The number of babies born with certain types of abnormalities has increased by up to 50 per cent in five years, research by a medical charity has found.

The Birth Defects Foundation (BDF) calculates that 45,000 babies are born each year with defects ranging from spina bifida – an abnormality of the spine – to prominent birthmarks or minor malformations of the hands or feet.

The total is six times higher than the Government's own figures for neonatal abnormalities and amounts to one in 16 of all births. However, the Office of National Statistics admits its own figures do not reflect the scale of the problem.

No clear explanation for the phenomenon has emerged but the use of recreational drugs by young mothers and an increase in oestrogen-like substances in the diet are possible factors.

While some types of abnormalities are declining, the charity's figures reveal a sharp rise in three specific defects – cleft lip or palate, gastroschisis (abnormality of the abdominal wall) and hypospadias (abnormality of the genitals).

The BDF will launch a campaign today to alert mothers to a five-point plan to increase the chances of having a healthy baby by taking account of their family medical history, taking folic acid supplements, reducing alcohol, stopping smoking and eating a balanced diet.

Sheila Brown, chief executive of the BDF, said: "The first question asked by any new mother is: 'Is my baby OK?' If the answer is no it is a dreadful shock. A defect does not just affect the baby – it is for life."

Professor Michael Patton, BDF medical director and head of medical genetics at St George's Hospital, Tooting, said the figure of one in 16 babies born with a defect was "frequently used in genetic circles". Research for the BDF showed the incidence of cleft lip or palate, requiring several operations to repair, had risen from 5.9 cases per 10,000 births in 1995 to 9.2 cases in 1999.

Hypospadias, a condition affecting boys in which the opening of the penis is situated on the underside of the shaft, had risen from 7.5 to 8.5 cases. In severe cases, the opening is situated so far back there is doubt about the gender of the child.

Professor Patton said: "Some substances in the diet, such as soya, contain phyto- oestrogens which it has been suggested could have a feminising effect on males."

The feminising effect of environmental pollutants was further highlighted yesterday in the Independent on Sunday, which reported on how fish in British rivers are developing female characteristics.

Gastroschisis, a weakness in the abdominal wall that leaves the baby with its intestines protruding at birth, had risen from 1.3 to 1.9 cases. The condition has been rising in both the US and the UK and is five times more common in teenage mothers than other age groups.

Professor Patton said: "One idea has been that perhaps it is the use of recreational drugs by teenage mothers that is behind this rise.

"I believe that the majority of malformations are not caused by the environment but are dependent on genetic factors. Where we see fluctuations there may be an environmental factor."

He said the "great success story" had been with spina bifida. By noting the trends and relating them to diet, the link with folic acid had been discovered, which was now given to all pregnant women. The incidence of the condition has been reduced by 60 per cent.

Figures collected by the Office for National Statistics show there were 7,284 children born in 2000 notified to the National Congenital Anomaly System. Planning for schools, hospitals and other services was based on official figures but these "seriously underestimated the true position," the BDF said.

The system was set up in the wake of the thalidomide scandal in the 1960s to serve as an early-warning system for environmental causes of birth defects. Thalidomide, an anti-nausea drug for pregnant women, was prescribed to thousands of mothers-to-be before it was identified as a cause of limb defects.

Ms Brown, of the BDF, said the Office for National Statistics relied on voluntary reporting by doctors and midwives of defects recognised at birth.

Many defects were not reported and others did not become apparent until the child was older. "Doctors are dealing every day with these conditions, yet the way they are counting them is irrevocably flawed," she said.

A spokesman for the statistics office said: "It has long been recognised that there is under-reporting. Efforts are being made to improve the system."

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