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U study investigates birth defects

By Isabella Bravo

A recent U study showed that pregnant women with a sexually transmitted disease and urinary tract infection are four times more likely to have a child with a birth defect.

“There’s a chance that a lot of women (don’t know they) are at risk,” said Marcia Feldkamp, a U professor of pediatrics and director of the Utah Birth Defect Network. “We may be underestimating (the number of mothers with STDs and UTIs).”

Feldkamp said 3 percent of babies are born with a birth defect.

Feldkamp studied gastroschisis, a birth defect in the abdominal wall where the intestines and sometimes other internal organs leak out through an opening. The baby is born with his or her organs on the outside.

“All babies born with (the defect) require emergency surgery, and they’re in the hospital for weeks and weeks,” said Jan Byrne, associate professor of maternal fetal medicine and clinical genetics at the U.

The survival rate for babies with the defect has increased from 60 percent to more than 90 percent since the 1960s, because the defect can be prenatally diagnosed, according to the study.

However, the number of children born with the defect has increased tenfold over last three decades in Utah, according to the U Health Sciences public relations department.

The national estimate for the defect is one in every 2,700, and in Utah, the estimate is higher with about one in every 2,200 to 2,500 babies born with it.

Jennita Reefhuis, an epidemiologist at the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities, said the defect is receiving attention from the center because it is increasing and the amount of data available to researchers.

“The study led by the Utah birth defect center is important because it focuses on (certain) infections (that are) more prevalent among younger mothers, and that is potentially preventable,” Reefhuis said.

Feldkamp’s study is one of many research projects taking place within the center’s National Birth Defect Prevention Study, which is the largest case control study of birth defects in the United States. The NBDPS includes more than 300 different proposed projects and researches more than 30 severe birth defects with unknown causes.

Although the centers have gathered data since October 1997 in some cases, Feldkamp noted that this national study now has enough cases to begin drawing conclusions.

“We’re now starting to analyze the data,” Feldkamp said. “This is the first in the United States to systematically look at birth defects.”

In her study, Feldkamp found that only women with STDs and UTIs within four weeks of pregnancy were more likely to have children with gastroschisis.

“Women who self-reported both an STD and a UTI were four times more likely (to give birth to babies with gastroschisis) than if they didn’t,” she said.

However, she said her research needs further corroboration.

Feldkamp sees a hole in the data collection. For the study, the researchers selected 240 women who had babies with gastroschisis and randomly selected 1,712 women who had babies without gastroschisis. These women submitted to a phone survey about their experience.

The study showed 43 percent of mothers with a UTI and a baby with gastroschisis reported having chlamydia. Eighteen percent of mothers without the birth defect reported having the STD.

“Chlamydia’s a pretty bad player, but it’s the body’s inflammatory response (to chlamydia) that causes problems,” she said.

Chlamydia can cause infertility and urinary tract infections, and there is a connection, she said.

However, Byrne said the data doesn’t show that UTIs or STDs cause the defect.

“It may be the mother’s (immune system) response to the (infection) that causes the problem,” she said.

Feldkamp warned that this is the first study investigating the relationship STDs and infection have to the defect and that further research needs to be conducted.

The U.S. Congress opened the study in 1996 with eight original regional centers. The Utah center and a center in North Carolina began gathering data about birth defects in 2002.

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