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• Posted August 26, 2025

2 In 3 Women Have A Lifestyle Risk Factor For Birth Defects

Two-thirds of women in their child-bearing years have an increased risk for birth defects due to a lifestyle factor they can change, a new study says.

These risk factors — low levels of vitamin B9 (folate), unmanaged diabetes or exposure to tobacco smoke — increase the odds of a serious birth defect in any child they might have, researchers said.

Heart defects, cleft palates and defects of the brain and spinal cord are among the problems that could be headed off if women took steps to improve their health prior to pregnancy, researchers reported today in the American Journal of Preventive Medicine.

“Every growing family hopes for a healthy pregnancy and healthy baby,” said lead researcher Arick Wang, a senior health scientist at the National Center on Birth Defects and Developmental Disabilities.

“Understanding modifiable risk factors for birth defects helps families, health care providers, and public health professionals make data-informed decisions that can lead to healthier pregnancies and babies,” Wang added in a news release.

For the new study, researchers analyzed data for nearly 5,400 women of reproductive age, gathered between 2007 and 2020 as part of the National Health and Nutrition Examination Survey.

About 66% had at least one known risk factor for birth defects that could be addressed, results show.

These include: 

• Low folate status: Roughly 4 out of 5 women got less than the recommended daily amount of folic acid as part of their diet, and about 72% said they don’t take folic acid supplements.

• Diabetes: Nearly 5% of the women had diabetes, with almost 4% suffering from uncontrolled or undiagnosed diabetes.

• Obesity: Nearly 1 in 3 women had obesity.

• Tobacco exposure: Nearly 1 in 5 women had blood results indicating that they were either using or are regularly exposed to tobacco smoke.

• Food insecurity: More than 7% of the women had very low household food security, meaning normal eating patterns are affected by lack of money and food resources.

These risk factors contribute to birth defects by affecting a series of pathways essential for fetal cell growth and replication, Wang said.

“The most significant finding — that two-thirds of women of reproductive age had at least one modifiable risk factor — highlights how common these changeable risk factors are,” Wang said. “The good news is that they can be lowered.”

The results did include some good news.

Only about 1 in 5 women had low levels of red blood cell folate concentrations, Wang said.

“I was pleased to see a meaningful decrease of women with low blood folate status over the course of this study period — 2007 to 2020 — a decrease from 23.4% down to 17.9%,” Wang said.

“Since implementation of folic acid fortification of enriched cereal grains in the U.S., more than 1,300 babies are born without neural tube defects annually who might have otherwise been born with these conditions,” Wang continued. “Seeing the result of public health efforts in the improved folate status of women of reproductive age underscores both the effectiveness of population-level interventions and the meaningful progress we've made in preventing birth defects.”

More information

The American Academy of Pediatrics has more on reducing the risk of birth defects.

SOURCE: Elsevier, news release, Aug. 26, 2025