Anencephaly Cases Common Among Hispanics Here

Rare Birth Defect Cases Common Among Hispanics Here

The majority of the population in Central Washington’s Yakima, Benton and Franklin counties is Hispanic, and it is within these counties that a rare birth defect has been appearing with increased frequency.

According to health officials in the state, seven cases of the defect called anencephaly were reported in 2013. The Centers for Disease Control (CDC) indicate anencephaly is classified as a neural tube defect and is a serious birth defect in which a baby is born without parts of the brain and skull.

“Anencephaly happens if the upper part of the neural tube does not close all the way,” states the agency. “This often results in a baby being born without the front part of the brain (forebrain) and the thinking and coordinating part of the brain (cerebrum). The remaining parts of the brain are often not covered by bone or skin.”

The majority of infants born with this condition do not survive, and it is estimated to affect approximately 1 in every 4,859 babies in the United States. The current rate for Central Washington, however, has jumped to 8.7 cases per 10,000 births.

“About 60 percent of our cases were Hispanic, but the population in this area is about 50 to 60 percent Hispanic. It reflected the population here,” epidemiologist Mandy Stahre from the CDC said in a press interview on Tuesday. “A large proportion of the women were on Medicaid, but (the population) reflects that as well. It wasn’t something that made us go, ‘Ah, right here, poverty is the No. 1 thing.’ It’s probably a contributing factor.”

Just as Stahre couldn’t say poverty was the primary influencing factor for the increase in anencephaly cases, she and other experts couldn’t link the abnormality to being Hispanic, indicating only that Hispanics were being affected because they made up the majority of the population in that portion of the state.

None of the data thus collected indicates any one particular factor is at play, and it is likely that environmental and other external factors have something to do with the increase in neural tube defects.

“You can’t ignore all the risk factors that we see within this population and some of the reasons why we have the higher rates,” she said . “What we’ve been trying to target is if there’s something other than that, but you can’t ignore the social determinants of health: health disparities, high rates of obesity, lack of access to healthy foods, lack of access to prenatal care. … When you add all that together, you can’t say that that’s not contributing.”

Unfortunately the puzzle remains, and experts have been unable to find a link between any of the cases. Not only did they occur over a 300-mile area, they did not show up seasonally as would be expected if it were a pesticide issue. What’s more, the cases were not clustered in any specific region of the counties nor were they near any government test sites for nuclear weapons. The majority of cases were from households on public water which is routinely tested for contaminants.

Right now experts are unsure as to what the next steps should be to prevent the increase in anencephaly cases from increasing any more in frequency. The CDC and local health departments will continue to investigate, holding town listening sessions to develop a plan of action.

“We want to know what are the next steps we should do,” Stahre said. “Should we go back (to previous years)? Should we expand it to the entire state? These are questions we want the committee to weigh in on, to find the best way to use our resources moving forward.”

Before You Go

1
Government-sponsored baby showers
Associated Press
Since the 1930s, expectant mothers in Finland have received what amounts to a "welcome to the world, baby!" care package from their government. It includes clothing, a sleeping bag, bibs, first aid basics and, yes, even a cardboard box that can be used as a crib.

"Mothers have a choice between taking the box, or a cash grant, currently set at 140 euros," according to the BBC, "but 95 percent opt for the box as it's worth much more."
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Sitting up for labor
Getty
Though the practice of requiring women to lay flat on their backs has increasingly come under fire ("These days enlightened practitioners -- and better informed moms-to-be -- aren't taking labor lying down, or even in one place," What To Expect says), it's still the norm in many hospital across the United States, as well as in parts of Europe.

Not so in parts of Asia, Africa and Central and South America, the World Health Organization reports. In these countries, women move through various upright positions or squat while in labor. And that's a good thing: According to Rodale, research has shown that sitting, standing and kneeling during labor (or all of the above) can shorten early labor, and also decrease the need for epidural anesthesia.
3
A laughing (gas) matter
Getty
Though epidural or spinal anesthesia is the most common type of pain medication used by laboring women in the U.S. (CDC data from 2008 showed 61 percent of women from 27 states who gave birth vaginally had epidural or spinal anesthesia), nitrous oxide, or "laughing gas," is far more popular overseas. It's used by roughly 60 percent of women in the United Kingdom, and up to half of laboring women in Australia, Finland and Canada. According to a 2012 review by the Cochrane group, it's a safe and effective option, but experts say it is unlikely to become popular in the U.S. anytime soon, in part because hospitals do not have the correct equipment or ventilation.

As Slate reports, women who use laughing gas during childbirth -- inhaling it through a mask -- say it doesn't altogether eliminate the pain, but distracts them from it.
4
Seaweed soup, anyone?
Stacey Newman via Getty Images
Many cultures have customs dictating what women should and shouldn't eat during pregnancy, childbirth and beyond, but few foods are as closely tied to labor and delivery as miyeokguk, or Korean seaweed soup. Also called "birthday soup," the nutritious, hearty broth continues to be one of the first things women eat after delivery. "In the olden days," women also used to eat it for a month prior to giving birth -- and some still do, the Korea Tourism Organization explains. (The tradition in Korean culture was inspired by whales eating seaweed -- which is high in various vitamins and nutrients -- after giving birth, Time reports.) "Eating [this soup] on birthdays is seen as a way to remind children not to forget the pain of childbirth and to appreciate the care given to them by their mother."
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Pride of place for the umbilical cord and placenta
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In many places around the world, the umbilical cord and placenta -- which support the baby by providing oxygen and nutrients during pregnancy -- also have strong symbolic significance, and are treated accordingly after birth. In Turkey, for example, it's not uncommon for women to bury babies' umbilical cords at schools or mosques -- in the hope that their children will be devoted to education or religion -- or keep them at home, to ensure devotion to the family. In some parts of Africa, the placenta is buried in an important spot -- often under a tree, at home or in an open field.

In the U.S., the placenta is generally discarded by the hospital or birthing center where a woman delivers, although some women save theirs and consume it in pill form, believing it helps boost well-being (a controversial claim).
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A month to rest
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"Sitting the month,” a custom observed in China and Vietnam, mandates that women stay largely confined to their homes for at least the first few weeks after giving birth. "New mothers are pretty much expected to just sit around in pajamas for a month to recover from childbirth," NPR reports. Moms also follow specific guidelines about what they can and can't eat and drink (nothing too hot or cold) or do (take a shower).

As The Daily Beast explained in its takedown of the U.S.'s postpartum practices, "some version of the lie-in is still prevalent all over Asia, Africa, the Middle East and particular parts of Europe; in these places, where women have found the postpartum regimens of their own mothers and grandmothers slightly outdated, they've revised them." Definitely trickier to pull off in the U.S., one of the few countries left with no federally-mandated paid maternity leave.
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Postnatal care down there
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Postnatal care is pretty robust in France, as writer Claire Lundberg discovered when she delivered abroad, and can include something known as "la rééducation périnéale" -- therapy designed to help strengthen or "re-train" the vagina in the hopes of avoiding the pelvic problems that can plague women after birth. The service has been funded by French social security since 1985.
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Saying "no" to sex
Getty
Here in the U.S., many women get the green light to have sex again at their six week postpartum check-up, but in Papua New Guinea, mothers wait much longer before they have intercourse. It is a common cultural practice for women to remain abstinent until they wean their babies, whether that takes weeks, months or even years.
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Paid leave, guaranteed
Getty
Unlike their peers in the U.S. -- where, again, there is no federally-mandated paid maternity leave and many women are guaranteed a mere 12 weeks of job protection -- new mothers (and increasingly also fathers) elsewhere in the world are sometimes guaranteed more than a year of paid time off. In Sweden, Germany, Norway and Denmark, parents are offered more than 50 weeks of paid leave, which they can divvy up between mom and dad after birth or adoption, while in the Czech Republic, mothers or fathers are able to take up to 48 months of paid parental leave, according to Mercer, the global consulting firm.

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