Kristie McNealy, MD

A study published online in the Maternal and Child Health Journal has revealed a link between major birth defects and preterm birth. The research, which addresses one of the goals set forth in the PREEMIE Act, looked at the birth data from 13 states for the time period of 1995-2000 (about 30% of all US births during that time) and analyzed the outcomes of singleton live births between 24 and 44 weeks gestational age. And no, that’s not a typo, I meant to type 44 weeks . . .

Overall analysis showed that birth defects were twice as common in preterm births between 24 and 36 weeks as compared to term babies born during the same time period. In total, birth defects were seen in 8% of preterm births. Babies born between 24 and 31 weeks were 5 times more likely to have a birth defect. The most common birth defects seen in preemies were nervous system defects like spina bifida, and heart defects.

There were some problems in the data sets used in this study, because some centers participating in the surveillance program the data set came from, reviewed birth records in the case of preterm birth. It is possible that this review resulted in more accurate recording of birth defects in preemies. The authors also noted that it was difficult to determine if certain diagnoses like hydrocephalus were actually birth defects, or improperly coded cases of hydrocephalus resulting from complications of prematurity. Even with these complications, I think this study raises interesting questions about shared risk factors for certain birth defects and prematurity. This is particularly true in the case of data linking folic acid intake to reduction in both neural tube defects and preterm birth.

Birth defects and preterm births are the two leading causes of infant death in the United States, but prior to this study, there hadn’t been a comprehensive look at the correlation between birth defects and prematurity in the United States. There are hopes that further study may be able to determine the factors that link the two phenomenon, giving future avenues for treatment and prevention of both birth defects and preterm birth.

Were any of your preemies impacted by birth defects? Were they delivered early in order to address problems caused by the birth defect, or did you go into preterm labor spontaneously? Share your story in the comments section!

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