Rate of Major Birth Defects in Nova Scotia Examined

A study commissioned by the Joint Action Group shows that in Sydney the rate of infants born with no major birth defects was marginally lower than the rate in the rest of Nova Scotia.

In Sydney, the rate was 96.6 per cent of infants born between 1988 and 1997, compared with a rate of 97.3 per cent in Nova Scotia outside Sydney.

Based on 390 births --the average annual number of births in Sydney --the difference in rates means three more infants are born each year with a major birth defect in Sydney than in the rest of Nova Scotia.

The report, titled Birth Outcomes Among Residents of Cape Breton County, was presented to the Joint Action Group, or JAG, today in Sydney. The report's purpose was to compare birth outcomes between women living in Sydney, Cape Breton County and the rest of Nova Scotia between 1988 and 1997. It was not designed to provide information on potential causes.

The consensus among clinical researchers is that there are multiple causes of birth defects. About 65 per cent of all birth defects across Canada have no known cause. Twenty-five per cent are thought to be related to genetics while 10 per cent are thought to be related to maternal factors such as infection, illness or medication use during pregnancy.

"The Birth Outcomes report provides the Health Studies Working Group of JAG with important information about the health status of our community," said Michelle Gardiner, chair of the working group. "It will be helpful to us as part of the JAG process to assist us in studying what effects, if any, the Muggah Creek watershed has had on the health of the people in Sydney."

Low birth weight, prematurity and mortality rates were also reviewed. There was no difference in low birth weight and prematurity rates between Sydney, Cape Breton County and the rest of Nova Scotia. There was an increase in perinatal mortality rates in Sydney and Cape Breton County, but after adjusting for risk factors, the rates were closer to that of the rest of Nova Scotia. This finding supports the importance of reducing risk factors to ensure a healthy pregnancy.

"There is still much more for us to learn about major birth defects and the reason for their occurrence," said Dr. Cheryl Conrod, chief of obstetrics at the Cape Breton Healthcare Complex. "In the meantime, it is important for women in Sydney and the rest of the province to take the necessary steps to ensure a healthy pregnancy and a healthy baby."

Women of child-bearing years are reminded to:

• take folic acid as a daily vitamin supplement
• avoid smoking, alcohol and drugs
• eat a balanced diet and avoid obesity
• obtain prenatal education
• see a doctor in the first three months of pregnancy
• schedule regular appointments for the duration of the pregnancy
• contact their physician or public health nurse for more detailed information

"Women should contact their local public health office or physician to learn more about options for prenatal education," said Dr. Jeff Scott, provincial medical officer. "The Department of Health will continue to monitor the situation in Sydney and support such programs as the Reproductive Care Program, which has played a major role in improving standards of care for new moms across the province."

Literature on the potential relationship between exposure to some chemicals and major birth defects was reviewed while the Birth Outcomes report was being prepared. Studies of populations living close to waste sites have not consistently shown an increase in risk of major birth defects for the residents.

The Department of Health has written letters in support of research proposals attempting to look at chemical exposures among pregnant women in Sydney.

The Birth Outcomes report was conducted at the request of the Health Studies Working Group. It was peer-reviewed by two national experts in perinatal epidemiology as well as by obstetricians, neonatologists and pediatricians in Sydney and in Halifax. Their suggestions are included in the final report.

Data was provided by the Reproductive Care Program, recognized as the provincial authority on maternal and newborn health. The program has played a major role in improving standards of care for Nova Scotia mothers during the 25 years since its inception.

JAG's mandate is to seek solutions to the environmental and health risks associated with the Muggah Creek watershed as outlined in the memorandum of understanding signed in September 1998 with partners Cape Breton Regional Municipality, the province and the federal government.