PETALING JAYA: About 30% of deaths among children under five in Malaysia between 2018 and 2022 were related to congenital conditions.
It is the second most common cause of death in this age group, followed by nervous system malformations and surgically-related issues, according to the Health Ministry (MOH).
CLICK TO ENLARGEIt said this accounted for about 55% of congenital anomalies, making them the most common type reported nationwide, including conditions such as Down syndrome, Edwards syndrome and Patau syndrome.
MOH does not capture data on live births with congenital conditions.
“Existing reporting mechanisms are primarily focused on mortality outcomes, including stillbirths and deaths among children under five years of age attributable to congenital causes.”
Currently, there is no stand-alone national programme dedicated specifically to preventing congenital disabilities.
“However, preventive efforts are integrated into broader maternal and child health services, including pre-pregnancy care at primary healthcare clinics where women receive counselling and health assessments before conception,” it said.
Doctors caution that while many congenital anomalies are unavoidable, there are conditions and risk factors that families should be aware of.
Consultant paediatrician and neonatologist Datuk Dr Musa Mohd Nordin said congenital anomalies like Down syndrome are largely unavoidable.
“They are random genetic events not caused by anything a parent did or didn’t do.
“Pregnancy at a maternal age below 35 years old significantly reduces the risk of chromosomal trisomies,” he said.
Early detection through antenatal screening as early as 10 weeks of pregnancy allows forinformed decision-making and preparation, he added.
However, Dr Musa noted that a significant portion of congenital disabilities reported by MOH, i.e. the remaining 45%, have preventable elements.
“Many neural tube defects can be prevented with adequate folic acid intake,” he said.
“Congenital heart defects, while not 100% preventable, have risk factors that we can manage.
“Optimising maternal health, avoiding harmful exposures and taking proper vaccinations, like rubella, chicken pox, and hepatitis B vaccines, can significantly reduce the risk.”
Dr Musa noted that unmanaged diabetes is a major factor contributing to the problem.
“High blood sugar in the first trimester, when the baby’s organs are forming, significantly increases the risk of heart defects and neural tube defects.
“Others include congenital rubella syndrome and congenital varicella syndrome, for example, which may lead to multiple anomalies in babies. Yet, both can be avoided if women are vaccinated against measles, mumps, rubella (MMR), and chickenpox before pregnancy.”
Other factors also include advanced maternal age (often linked to career timing), he said.
Similarly, maternal-fetal medicine consultant Dr Muniswaran Ganeshan said iodine deficiency is another common concern that does not cause congenital disabilities but is associated with impaired neurological development in the newborn.
“Maternal exposure to certain supplements, such as retinoids, which are commonly used to treat acne and skin conditions, is associated with fetal brain, heart and facial abnormalities.
“Mothers with certain conditions – including those who conceive via IVF (in-vitro fertilisation), carry multiple pregnancies, or have congenital heart disease or inherited genetic disorders – may face a higher risk of having babies with congenital anomalies.
“About 20-25% of congenital disabilities come from genetic causes. Spontaneous genetic changes cannot be prevented, but inherited conditions can sometimes be avoided through IVF and embryo screening (e.g. thalassemia or certain X-linked disorders),” he said.
He added that with better antenatal care today, ultrasounds, and genetic screening, which is often done with just a blood test, many conditions can be detected early.
“Some can even be treated during pregnancy or after birth.
“For prevention, both parents should see a doctor before conception to optimise their health before pregnancy.
“If you have a genetic condition, this can also be avoided through certain pre-pregnancy interventions, such as preimplantation genetic testing, which is also an option to prevent inherited genetic conditions.”
Source: birth-defects-claim-30-of-young-lives
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