State health officials have released new data showing a rare birth defect in a three county area of the state remains above expected rates. The Department of Health will convene an advisory committee to review options for further investigation and prevention.
Seven cases of the fatal birth defect anencephaly were reported in 2013 in Yakima, Benton, and Franklin counties — higher than expected for the fourth consecutive year. The 2013 rate of 8.7 per 10,000 births is similar to the rate for 2010-2012, and remains well above the national rate of 2.1 per 10,000 births.
Anencephaly is a rare neural tube birth defect in which a baby’s brain and skull don’t fully form in the first month of pregnancy. Babies with anencephaly die soon after they’re born. The causes of anencephaly aren’t fully understood. Women can reduce the risk by taking folic acid. Because many women don’t know they’re pregnant until after initial brain and spinal cord formation, the Centers for Disease Control and Prevention recommends all women of childbearing age take folic acid daily.
The state Department of Health worked with local and federal health partners to look for common exposures or experiences among women with affected pregnancies and how they differed from women with healthy pregnancies. The investigation used medical records to compare the areas where women live, environmental factors, prenatal care, vitamin use during pregnancy, and other factors.
That phase of the investigation was inconclusive. There were no significant differences between infants with anencephaly and healthy infants in the area, yet medical records showed low rates of folic acid vitamin use for this area. This is consistent with information from the Pregnancy Risk Assessment Monitoring System that showed fewer women in the three counties report early use of prenatal vitamins or folic acid supplements than women in the rest of the state for 2009–2011.
Health officials are convening an advisory committee including national experts on neural tube birth defects; staff from the Centers for Disease Control and Prevention; local and state health officials; and others to assess further investigation. State and local health will hold listening sessions with the public to learn more about community concerns that might be related to anencephaly and other neural tube defects in the area. Information from these listening sessions will be given to the advisory committee to help ensure community concerns are addressed when determining next steps.
Since the investigation began, local health officials have provided health care professionals in the region with prevention advice. Meanwhile, state and local health officials urge women of childbearing age to follow federal recommendations for taking folic acid daily. It can be taken as a supplement or in fortified foods. Women are advised to see a health care professional when planning a pregnancy and begin prenatal care in the first trimester. More information on anencephaly is available on the CDC Birth Defects website.
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