Because learning about birth defects is so important, organiza­tions such as the March of Dimes, which is dedicated to prevent­ing birth defects, and the U.S. Congress are working together to educate the American public. In fact, in 2002 Congress passed the Birth Defect Prevention Act, which has as one of its goals in­forming and educating the public about birth defects. An expert at the March of Dimes explains: “It is critical that women and their health care providers be educated about what they can do to improve birth outcomes.”

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Cymbalta Lawsuit: All birth defects have a physical effect on a person, which varies significantly depending on the specific birth defect. Structural birth defects affect the physical makeup of the body. When a baby has a structural birth defect, some part of the body is miss­ing or malformed. The affected body part can be internal or ex­ternal. Structural birth defects such as a missing or extra finger or toe can be relatively harmless, but the absence of kidneys or lack of development of parts of the brain can be fatal. Some structural birth defects, such as a clubfoot, affect an individual’s ability to walk. Cleft palates impair speech, while malformed or missing fingers or hands affect a person’s fine motor skills. Gas­trointestinal defects, which involve incomplete development of the esophagus, stomach, intestines, or rectum, lead to problems swallowing and digesting food and eliminating waste.

Functional birth defects affect the way the body works. De­pending on the organs involved, functional birth defects can cause problems throughout the body. For example, problems in the functioning of the brain cause learning disabilities, mental retardation, deafness, blindness, speech problems, and limited mobility. Other functional birth defects can affect a person’s cir­culation, breathing, and digestion. Inherited diseases are func­tional birth defects. Functional birth defects can cause secondary problems. For in­stance, many people with cerebral palsy, a birth defect that af­fects the part of the brain that controls movement, often have seizures. Problems in the development of their brains cause nor­mal electrical connections to be disrupted. Secondary problems are also common with structural defects like spina bifida, where underdeveloped nerves lead to paralysis, lack of bowel and blad­der control, brain malformations, and learning disabilities.

Birth defects have many different causes. Often the culprit is a faulty gene. Genes are the body’s instruction manual. They are contained in forty-six capsulelike structures called chromosomes, which are found in every cell in the body. Chromosomes are organized into twenty-three pairs. Each pair of chromosomes contains 140,000 genes that give a person his or her unique characteristics and tell the body how to develop and function.

When a fetus is conceived, each parent passes on twenty-three chromosomes containing seventy thousand genes. The chromo­somes pair up within the fertilized egg, which divides and redi­vides, forming new cells. Each new cell contains two copies of the original seventy thousand genes. Each time a fetus is con­ceived, each parent passes on one-half of each pair of genes, but in different combinations. The result is that every person, with the exception of identical twins, receives a different mix of genes. This is why siblings do not always look alike.

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Cymbalta Lawsuit: When the sperm and egg first unite, cells start divid­ing to form an embryo. In the first month of pregnancy the embryo grows to be about half an inch long. Brain cells begin to develop, as do arms and legs. The eyes also form, although scientists doubt the embryo can see. In the next two months internal organs begin to de­velop, as do fingers and other body parts. The embryo reaches three to four inches in length, and is now known as a fetus. Brain cells continue to grow, and by the end of the third month the fetus’s heart is pumping blood. His or her sexual organs are also formed. At this time the fetus’s gender can be determined.

During the second three months of pregnancy the fe­tus grows to about a foot in length and about one and one-half pounds in weight. By this time the fetus can open and close its eyes and move its fingers. The mother can feel the fetus moving inside her. By the sixth month, the fetus has hair. Despite all this growth, many of the fetus’s organs, such as the lungs and brain, are not yet fully developed. In the last three months of pregnancy the fetus starts making body fat and gaining weight. During this time brain growth continues.

Inherited diseases are also transmitted through genes. If there is a family history of an inherited disease, a gene that causes the disease can be passed to the fetus from either parent. Moreover, parents can carry and pass on a disease gene even if they are un­affected by the disease. Once the gene is transmitted, the baby may develop the disease or, like the parent, become a carrier. Whether or not the baby develops the disease depends on a number of factors. In some cases both parents must transmit the defective gene in order for the disease to develop. This is the case in cystic fibrosis, an inherited disease that affects the breathing and digestion of one out of every thirty-three hundred babies bom in the United States each year. Thalassemia and sickle-cell anemia affect the ability of a per­son’s red blood cells to deliver oxygen and nutrition to the body. Of the two, sickle-cell anemia is more common. Over sixty thou­sand Americans have the disease. Derrick and Laquana, a couple who both carry the sickle-cell gene, explain: “Turns out we both have the sickle trait. . . . We know it won’t be easy, but we’ve thought about it a lot. If the baby is bom with sickle cell, she is going to get the best loving and caring any baby can get.

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Cymbalta Lawsuit: Even when there are no genetic abnormalities, birth defects often develop when the fetus is exposed to potentially harmful sub­stances. Any substance that enters a pregnant woman’s blood­stream is transmitted to the developing fetus through the placenta. Consequently the fetus is exposed to everything that enters the mother’s blood, whether by mouth, air, or intravenously. So, if an expectant mother uses cocaine, for example, the fetus is exposed to the harmful effects of the drug. Substances like alcohol, cigarettes, medications, illegal drugs, contaminated food, household chemicals, and infectious agents all can lead to birth defects. This is because fetal cells are unde­veloped and fragile, so the fetus is more sensitive and vulnerable to the effects of these substances. Some substances do not harm the mother, but they damage the fetus. When the substance can hurt the mother, it has an even more pronounced effect on the fe­tus. The damage can take place any time during pregnancy, but the fetus is most vulnerable in the first trimester, when brain cells are developing.

For example, alcohol can have a harmful effect on anyone, es­pecially when it is abused. Small quantities of alcohol, such as an occasional glass of wine, usually do not harm an adult but have the potential to cause fetal alcohol syndrome (FAS), a birth dis­order caused when the fetus is exposed to alcohol. Such exposure can cause mental retardation, hearing and vision problems, growth deficiencies, and facial abnormalities. As a consequence, babies bom with fetal alcohol syndrome face both physical and mental disabilities.

Approximately thirty-three out of every one thousand babies bom in the United States each year have fetal alcohol syndrome. Teresa, the adoptive mother of John, a young man with fetal alco­hol syndrome.  Exposure to cigarettes and illegal drugs has a similar effect on a developing fetus. Cigarette smoke has been linked to prema­ture birth and problems in babies’ lungs. Usually premature ba­bies are extremely small and their organs are not fully developed. Therefore, they often face serious health problems at birth as well as lasting disabilities like hearing loss, blindness, heart problems, mental retardation, and cerebral palsy. Drugs like cocaine, crack, and heroin can cause bleeding in a fetus’s brain. This leads to brain damage and developmental delays, including mental re­tardation.

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Cymbalta Lawsuit: Prescription drugs, too, can harm a fetus. For example, isotret­inoin, a drug used to treat acne and commonly called Accutane, works by slowing the growth of skin cells in individuals with acne. The drug is so powerful, however, that when a fetus is ex­posed to it, isotretinoin slows or stops the growth of all fetal cells. As a consequence, 35 percent of all babies born to pregnant women treated with the drug are born with birth defects. These include blindness, mental retardation, malformed organs, and physical deformities.

Household chemicals like those used in paints, cleaning sol­vents, and pesticides have a similar effect. Although exposure to low levels of most chemicals poses little risk, daily heavy expo­sure, such as that which pregnant women in the dry cleaning or house painting business experience, can interfere with the for­mation and growth of fetal nerve cells. This can cause learning disabilities and mental retardation in the baby.  Infectious agents that cause sexually transmitted diseases can also cause birth defects when a baby is exposed to the infectious agents as the baby passes through the birth canal. Exposure to these germs can cause blindness, hearing loss, cerebral palsy, and mental retardation.

Other infectious agents such as Listeria, a bacterium that causes food poisoning, also affect fetal brain development. Listeria is such a threat to the welfare of unborn babies that in 1992 the Centers for Disease Control issued a warning advising pregnant women to avoid eating processed meats such as bologna, which is some­times tainted with Listeria. Pregnant women exposed to listeria do get sick, but it is the fetus who is most in danger.

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