prenatal care Archives | Galiher DeRobertis & Waxman LLP

Researchers Perform World’s First Stem Cell Treatment During Fetal Surgery for Spina Bifida

Posted on October 1, 2023November 21, 2024 by Galiher DeRobertis & Waxman

News of a wanted pregnancy can be the most wonderful of tidings an expectant couple can get. In most cases, that joy continues throughout the pregnancy. However, some expectant and new parents get news of birth defects, such as spina bifida, that can dampen their joy.

Doctors and medical researchers continually work to create treatments that can help minimize the effects of these birth defects and help affected children live long, healthy lives. Recently, doctors performed the first in-utero stem cell treatment to help a fetus diagnosed with spina bifida.

What is Spina Bifida?

Spina bifida is a condition in which the spinal tube in a fetus doesn’t close. It affects about 1 in every 2,750 births in the United States. There are three main types, based on the size of the opening and whether a sac containing fluid, nerves, and/or part of the spinal column grows outside the back. Spina bifida is considered a neural tube defect, and it can cause physical and intellectual disabilities. Health issues can be mild or severe, including paralysis, water on the brain, and incontinence.

What Causes Spina Bifida?

The exact causes aren’t known, but nutrition plays a role. People who are pregnant or are trying to become pregnant should take a folic acid supplement containing 400 micrograms of this vitamin, as is contained in most prenatal vitamins. Diabetes in the mother and usage of certain prescription and nonprescription medications may also cause neural tube defects, so it is important that people who want to become pregnant work with their doctor to minimize risks. The formation of the spinal tube happens very early in pregnancy, so spina bifida may occur before a person knows they are pregnant, so prevention before pregnancy is important.

How is Spina Bifida Treated?

Often spina bifida can be diagnosed during pregnancy, but other instances aren’t apparent until birth. Surgery to close the gap and minimize damage to the nerve and the spinal column is the main treatment. Some cases can be treated with surgery in-utero, while others will need to be treated later. The longer the spine remains open, the more damage to the nerves and spine, which is why fetal surgery has been a positive development for expectant parents when it is considered an appropriate treatment method.

Why is this Stem Cell Surgery a Big Development?

Although fetal surgery can help limit spinal damage and improve outcomes, many children born after fetal surgery still require the use of wheelchairs or leg braces. The researchers at the University of California at Davis hoped the use of stem cells would help prevent paralysis. They began with animal studies on English bulldogs, a breed that is prone to spina bifida and resultant paralysis, and lambs. The treatments were successful at repairing and restoring the damaged spinal tissue more than can be done with surgery alone, and the animals treated in this way were able to walk and play almost normally, according to bioengineer and study participant Aijun Wang.

After these initial successes, the researchers at UC-Davis were ready to begin trials on humans. Three fetuses received a stem cell patch as part of their spina bifida surgery. Researchers will follow them for six years to see how well the stem cell transplant helps them. The first baby, Robbie, born in September 2021, was expected to have full leg paralysis if her spina bifida was left untreated. Her mother, Emily, was thrilled when Robbie immediately began kicking her legs and wiggling her toes after birth. As Robbie and the other children grow up, researchers will be looking to see if they are walking and potty training, in particular, because urinary complications and leg paralysis are such common effects of spina bifida.

What Does This Mean for Future Treatments?

Because this is such an early treatment and the children who participated are still being studied, it is too early to say that this will be the gold standard treatment for spina bifida going forward, but it is promising. More research needs to be done, however, on ways to use stem cells to treat this and other neural tube defects. We will be watching for further developments to help affected fetuses and children.

5 Ways to Lower the Risk of Birth Defects

Posted on February 28, 2023November 21, 2024 by Galiher DeRobertis & Waxman

A new pregnancy – or planning for one – can be such an exciting time in a family’s life. And you will want to do whatever you can to ensure your baby will be happy and healthy.

The problem is that so much conflicting information can confuse parents-to-be about what really works to protect your baby’s health. Although it is impossible to guarantee that your child won’t be affected by birth defects, these time-tested tips can improve your chances of having a healthy baby.

See Your Doctor

Prenatal care is one of the most important actions to take. If you’re still in the planning stages, your doctor can help you manage your health to prepare for pregnancy. Then once you are pregnant, your doctor will monitor your baby’s and your health to ensure both are in good health.

If you have any chronic health conditions, such as diabetes or kidney disease, your doctor may recommend more screenings or more frequent visits to help ensure healthy development. Your doctor will also typically screen for any sexually transmitted diseases, as these can also cause birth defects and ongoing health problems.

Your doctor can also prescribe safe medication to help alleviate pregnancy symptoms if they interfere with your life.

Take Your Vitamins

A prenatal vitamin is a crucial part of a healthy diet before and during pregnancy. Folic acid, in particular, is a vital component. It has been proven to prevent birth defects such as spina bifida. These birth defects can happen before a woman even knows she is pregnant, which is why many health officials recommend that women of childbearing age ensure they are consuming 400 micrograms of folic acid each day to prevent brain and spine defects.

Once pregnant, your body will require increased nutrition as it supports you and your growing baby. If you have any questions about your nutrition and vitamin intake, your doctor is the best person to ask.

Get Your Vaccines

Certain diseases can cause severe birth defects during pregnancy, so it is essential to be up to date on vaccinations before becoming pregnant, including vaccinations to prevent human papillomavirus, measles, mumps, rubella, flu, tetanus, diphtheria, pertussis (whooping cough), and COVID-19. If you haven’t gotten all these vaccines, or they aren’t up to date, you may be able to take them during pregnancy. Concerns about your ability to receive these vaccines are best addressed with your doctor.

Maintain Your Health

Pregnancy can be physically taxing. Cravings can lead to unhealthy eating or unnecessary weight gain. The best option is to ensure that you are at a healthy weight and perform regular exercise before you get pregnant. If you are physically active already, you will likely be able to continue to exercise with some modification, which your doctor can advise you about.

In addition to taking your vitamins, make sure you’re eating a healthy and varied diet so you and your growing baby receive enough nutrition from food.

Although your changing body can make it challenging, especially toward the end of pregnancy, try to get adequate sleep to mitigate some of the fatigue that comes with being pregnant.

Stay Away from Harmful Chemicals

Finally, avoiding dangerous substances before and during pregnancy is essential in maintaining fetal health. As mentioned, many birth defects happen in the earliest stages of pregnancy, long before a woman realizes she is pregnant. So, avoiding chemicals that can cause damage is an important step in preparing for a baby. In fact, even if you aren’t planning to become pregnant, any woman of childbearing age is wise to minimize chemical exposure.

Some substances to avoid include alcohol, tobacco, marijuana, chemical solvents, pesticides such as glyphosate (found in Monsanto’s Roundup and other bands), herbicides, and cleaning products. Because these chemicals have been linked to cancers and other diseases in addition to birth defects, avoiding these substances is in the mother’s best interests, too.

Prevention and Prenatal Care Can Lower the Risk of Birth Defects

Posted on October 10, 2022November 27, 2024 by Galiher DeRobertis & Waxman

About three percent of babies born in the United States each year are affected by birth defects. Birth defects, also called congenital defects or malformations, may be mild or severe, and can have a profound effect on the child and the family.

Care Providers Can Bridge the Gap

Access to prenatal care has been shown to have a sizable impact on fetal health. Health care providers can perform tests during pregnancy to assess the health of the fetus and screen for potential birth defects. They can also ask questions to help see if the pregnant person has been exposed through work or location factors to harmful chemicals or pesticides that could cause birth defects. For example, farm workers and workers in semiconductor factories have been found to have higher rates of birth defects because of exposure to chemicals before or during pregnancy.

Health care providers will also help plan adequate nutrition and connect women who can’t afford high-quality food and prenatal vitamins with services. Health care providers can perform diagnostic tests to assess the risks for and diagnose some birth defects to help potential parents make informed decisions and plans for their children.

But many prospective parents don’t have adequate access to prenatal care to help prevent birth defects. They also may not have received the vaccinations necessary to prevent pregnancy complications. These factors can create a disparity in birth outcomes between socioeconomic and ethnic groups and lead to higher rates of birth defects in groups who are less likely to receive conscientious health care and to be able to afford high-cost procedures and devices.

Causes and Types of Birth Defects

Although some birth defects are genetic and may not be easily prevented, other birth defects are caused by exposure to dangerous chemicals, lack of adequate nutrition, and exposure to infectious diseases before and during pregnancy. Some birth defects may be caused by a combination of factors, such as a genetic factor that increases sensitivity to an environmental hazard. Still other defects can be caused by lifestyle choices, such as drug use or smoking, and parental medical conditions, including diabetes or obesity. About 30% of the causes of birth defects are known, but the remaining 70% are of unknown or indistinct origin.

Birth defects may be visible or invisible. For example, limb abnormalities, Down syndrome, neural tube defects, and cleft palates are usually visible at birth or soon after. However, defects in internal organs or visual or hearing deficits may not be easily determined at birth. Many birth defects may lead to higher risk of death. In fact, worldwide, nearly 240,000 Infants die each year within 28 days of birth. Birth defects contribute to another 170,000 deaths of children ages 1-5 each year. In the United States, birth defects are estimated to be the cause of 20% of infant deaths.

Birth defects may also lead to lifelong disability, causing emotional distress and financial hardship for their families. Surgeries and medications may be able to cure some birth defects or provide relief from the symptoms, but other birth defects victims may need medical aides and expensive devices to ensure they can lead a full life.