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New research highlights factors that can increase the chances of a baby being born with a birth defect.
It has been known for some time in the UK that birth defects, or congenital anomalies, are a major cause of infant death which varies across ethnic groups. Studies in the last 20 years considered marriage to a blood relative (consanguinity), as a cause of birth defects, but these studies didn't address other risk factors such as lower economic status (deprivation).
The work is published in The Lancet.
Findings from researchers at the Universities of Bradford and Leeds, funded by the National Institute for Health Research (NIHR), confirm that the two main factors associated with increased risk of birth defects are (1) being born to an older mother or (2) being born to parents who are blood relations.
In addition, the research also confirmed that socio-economic status (levels of deprivation) had no effect on the relative risk of birth defects, despite two-thirds of the mothers participating in the study coming from the most deprived fifth of the British population.
Results also showed that higher levels of maternal education halved the risk of having a baby with a defect across all ethnic groups.
Geneticist and lead author Dr Eamonn Sheridan, from the University of Leeds, says: "It is important to note that the vast majority of babies born to couples who are blood relatives are absolutely fine, and while consanguineous marriage increases the risk of birth defect from 3% to 6%, this risk is still small."
The study, funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Leeds, York and Bradford, and the largest of its type ever conducted, examined detailed information collected about more than 11,300 babies involved in the Born in Bradford (BiB) project, a unique long term study which is following the health of babies who were born in the city at the Bradford Royal Infirmary between 2007 and 2011.
The research team found that the overall rate of birth defects in the BiB babies was approximately 3% - nearly double the national rate.
Each year, approximately 1.7% of babies in England and Wales are born with a birth defect such as heart or lung problems, or Down's Syndrome, which may be life-limiting. These disorders occur as a result of complex interactions between genetic and environmental factors, or because of damage from infections such as rubella and cytomegalovirus.
While the BiB cohort includes a total of 43 different ethnic groups, the largest ethnic groups were Pakistani (45%) and White British (just under 40%).
In the Pakistani subgroup, 77% of babies born with birth defects were to parents who were in consanguineous marriages. In the White British subgroup 19% of babies with an anomaly were born to mothers over the age of 34. Links between the age of mothers and the prevalence of birth defects are already well-established.
It is estimated that more than a billion people worldwide live in in communities where consanguineous marriage is commonplace.
The Bradford/Leeds study is the first to explore potential causes of birth defects in a population where there are enough numbers in both consanguineous (marriage to a blood relation) and non-consanguineous groups to generate statistically significant conclusions.
Professor Neil Small, co-author of the study from the University of Bradford, says: "The research is of particular importance to Bradford, because half the babies born in the city's one maternity hospital have a parent whose family origin is Pakistan. But the findings also are relevant across the world in countries where consanguineous marriage is a cultural norm.
In Bradford, there are initiatives that seek to raise community awareness and services such as genetic counselling and testing accessible to couples who are married or considering marriage to a blood relative. It is not our intention to counsel couples about who they choose to marry. But we do want to ensure couples are aware of any risks, so they can make informed choices when planning their families."
University of Bradford
Known for its strong emphasis on employability skills and knowledge transfer work with businesses, the University has a truly global make up with over 20 per cent of its student population being international. The University is also a leader in sustainable development and education, and is within the top ten greenest universities in the UK, according to the Green League 2013.
National Institute for Health Research
This particular Born in Bradford project was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Leeds, York and Bradford. The views expressed in this news release are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Original press release:http://www.eurekalert.org/pub_releases/2013-07/uol-kfi070313.php