Alarming rise in birth defects

By JEREMY LAURANCE in LONDON

The number of babies born in Britain with certain types of abnormality has increased by up to 50 per cent in five years, a medical charity says.

The Birth Defects Foundation calculates that 45,000 babies are born each year with defects ranging from spina bifida - an abnormality of the spine - to prominent birthmarks or minor malformations of the hands or feet.

The total is six times higher than the Government's own figures for neonatal abnormalities and amounts to one in 16 of all births.

However, the Office of National Statistics admits that its own figures do not reflect the scale of the problem.

No clear explanation has emerged, but drug use by young mothers and an increase in oestrogen-like substances in the diet are possible factors.

While some types of abnormality are declining, the foundation's figures reveal a sharp rise in three specific defects - cleft lip or palate, gastroschisis (abnormality of the abdominal wall) and hypospadias (abnormality of the genitals).

It is campaigning with a five-point plan to alert mothers to take account of their family medical history, take folic acid supplements, reduce alcohol, stop smoking and eat a balanced diet.

Foundation medical director Professor Michael Patton, who is head of medical genetics at St George's Hospital in Tooting, said the figure of one in 16 babies born with a defect was "frequently used in genetic circles".

Research for the foundation showed that the incidence of cleft lip or palate, requiring several operations to repair, had risen from 5.9 cases per 10,000 births in 1995 to 9.2 cases in 1999.

Hypospadias, a condition affecting boys in which the opening of the penis is situated on the underside of the shaft, had risen from 7.5 to 8.5 cases.

In severe cases, the opening is so far back that there is doubt about the gender of the child.

Professor Patton said: "Some substances in the diet, such as soya, contain phyto-oestrogens which it has been suggested could have a feminising effect on males."

The feminising effect of environmental pollutants was further highlighted in the Independent on Sunday, which reported on how fish in British rivers were developing female characteristics.

Gastroschisis, a weakness in the abdominal wall that leaves the baby with its intestines protruding at birth, had risen from 1.3 to 1.9 cases, the professor said.

The condition has been rising in the US and Britain and is five times more common in teenage mothers.

Professor Patton said: "One idea has been that perhaps it is the use of recreational drugs by teenage mothers that is behind this rise.

"I believe that the majority of malformations are not caused by the environment but are dependent on genetic factors. Where we see fluctuations there may be an environmental factor."

He said the "great success story" had been with spina bifida. By noting the trends and relating them to diet, the link with folic acid had been discovered, and the acid was now given to all pregnant women. The incidence of the condition has been reduced by 60 per cent.

Figures collected by the Office for National Statistics show there were 7284 children born in 2000 notified to the National Congenital Anomaly System.

Planning for schools, hospitals and other services is based on official figures, but the foundation said these "seriously underestimated the true position".

Foundation chief executive Sheila Brown said the statistics office relied on voluntary reporting by doctors and midwives of defects recognised at birth.

Many defects were not reported and others did not become apparent until the child was older.

A spokesman for the statistics office said: "It has long been recognised that there is under-reporting. Efforts are being made to improve the system."

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