China's birth defects blamed on pollution, unhealthy living

Incidence of problems in newborns has nearly doubled in 15 years and experts say environment and unhealthy lifestyle choices are the culprits.
Sunday, 11 November, 2012, 12:00am
Alice  Yanting.yan#scmp.com

Pollution and unhealthy lifestyle choices have contributed to a big rise in the incidence of birth defects on the mainland in the past 15 years, experts say.

Last year, birth defects were detected in 1.53 per cent of newborns in their first seven days of life, up from 1.09 per cent in 2000 and 0.87 per cent in 1996, the Ministry of Health said in September.

It said this rose to 5.6 per cent in the first five years of life because some conditions were hard to spot early on, but did not provide historical comparisons

Citing World Health Organisation statistics, the ministry said international figures were 6.42 per cent in poor countries, 5.57 per cent in middle-income countries and 4.72 per cent in rich countries.
There are about 16 million babies born on the mainland every year.

Ma Duan, deputy director of the Research Centre for Birth Defects at Shanghai's Fudan University, said that besides improved testing technology, which helped diagnose more birth defects, the deteriorating situation could also have been caused by pollution and some "personal lifestyle factors".

"Many birth defect cases may have a genetic background, but I think they are more related to pollution," he said. "Pollution is a prevalent problem across our country. In big cities, the quality of air and water is still not satisfactory, even though the authorities have launched campaigns to clean up the environment. In small cities and rural areas, the situation is even worse."

Ma said work pressures and addictions to tobacco, alcohol, hard drugs and online games could also lead to birth defects.

Qian Laidi, who runs birth defect consultations at Shanghai Red House Maternity Hospital, agreed pollution was a key culprit. She said young people tended to eat junk food but did little exercise in their spare time, resulting in poor quality of ovarian follicles and sperm.

The health ministry highlighted its efforts to prevent birth defects, with one programme that provided folic acid pills to 24 million rural women over the past three years resulting in a dramatic reduction in neural tube defects such as spina bifida and anencephaly.

Duan Tao, president of Shanghai No1 Maternity Hospital, said the most common birth defects included congenital heart disease, cleft palate, having too many fingers or toes, neural tube defects and hydrocephalus.
"The golden period in preventing birth defects is the time before pregnancy and the first three months of pregnancy," Duan said.

Authorities have been strengthening a "three-tier prevention system", featuring pre-pregnancy advice, pregnancy check-ups and newborn baby check-ups in order to decrease the incidence of birth defects.

Compulsory pre-marriage check-ups were abandoned in 2003 amid accusations they were an abuse of human rights. But some doctors expressed concerns that the end of compulsory check-ups would result in more birth defects. Cities including Beijing and Shanghai now offer free, voluntary check-ups to couples intending to have babies.

Last year, 8.89 million people had pre-marriage examinations, roughly a third of the 26 million people registering marriages, the health ministry said. Nine per cent were found to have medical conditions that would affect their children.

Ma said pre-marriage check-ups were effective in preventing genetic diseases, but birth defects included many other kinds of diseases and the check-ups could not find all the potential problems. "We can't rely on pre-marriage check-ups to wipe out all birth defects," he said.

Qian said ultrasonic and blood tests could not identify some defects, such as a club foot.

"For those would-be mothers diagnosed with a problematic fetus, we will discuss with paediatricians whether the pregnancy should be terminated," Qian said. "We will tell the family our advice, and the family themselves make the decision."

She said she had seen families suffer from having babies with birth defects.

"I once met with a wealthy family from Zhejiang. They have a baby with Down's syndrome and the baby's mother quit her job to look after him," she said. "The boy's illness has brought the family heavy burdens and they say they feel a loss of face and have lived in agony ever since."