Congenital defects are physical conditions that are present at birth. According to the CDC, congenital disabilities affect 1 in 33 babies born in the United States each year. Common congenital disabilities include limb defects, heart defects, and spinal defects. They may be diagnosed in the womb via ultrasound or identified shortly after birth. They can be caused by genetic defects or environmental factors such as infections and chronic health conditions during pregnancy (for example, diabetes or high blood pressure).
Many congenital disabilities can be corrected with surgery or managed with physical support systems such as braces and casts. Most children can live long, happy lives, and their quality of life can be further improved with physical therapy and other rehabilitation services.
Congenital Heart Defects
Congenital heart defects (CHDs) are structural heart defects that are present at birth. They are the most common type of birth defect and may be mild or severe. About 25 percent of babies born with heart defects will need surgery or other corrective procedures during their first year of life. Specific forms of CHDs include (among others) atrial septal defects, ventricular septal defects, patent foramen ovale, and aortic stenosis.
Children with CHD are prone to developing other issues as they age and may require treatment and monitoring for the rest of their lives. They may need to take antibiotics before certain procedures and pay special attention to oral care to prevent endocarditis (infection). However, they should be able to lead long and healthy lives.
Cleft Lip/Cleft Palate
Children may be born with a cleft lip alone, a cleft palate alone, or both. The incidence of orofacial clefts is about 1 in every 2,000 births in the United States. The cause is unknown; however, it does appear to have a genetic component that could be influenced by fetal environment. Studies have found that maternal diabetes, smoking during pregnancy, and the use of certain medications during pregnancy result in a higher risk of orofacial defects.
A cleft lip occurs when the lip tissue of the fetus doesn’t properly join before birth, leaving a gap in the upper lip. A cleft palate, on the other hand, occurs when the tissue forming the roof of the mouth doesn’t join properly prior to birth, leaving a gap in the palate. Cleft lips and cleft palates can affect a child’s hearing, cause more frequent ear infections, lead to increased dental concerns, and cause difficulty with feeding.
Treatment varies depending on the severity of the defects, and if surgery is needed, it is typically done within the first few months after birth. Additional surgeries may also be needed later in life, as well as speech therapy and specialized dental care.
About 1 in 1,000 babies in the United States are born with clubfoot, making it a very common birth defect. In about half of these cases, the child will have clubfoot in both feet. With this condition, the affected foot is usually smaller than normal, with a heel that points down while the foot is turned inwards. It is slightly more common in boys and appears to have a genetic component, since it can run in the family. Diagnosis usually occurs around the midpoint of pregnancy or, in some cases, after birth.
Despite appearances, clubfoot is usually not painful and doesn’t cause any major health problems unless it goes untreated. Children with clubfoot can usually be aided with a casting and bracing method called the Ponseti method. Surgery may also be an option. With proper treatment, children with clubfoot should be able to walk, run, and play like any other child once their treatment plan is complete.
Scoliosis is an inappropriate curvature of the spine, while kyphosis is the inappropriate forward curvature of the spine.
Congenital kyphosis is rare and is sometimes not observed until adolescence and usually presents as a rounded back with back pain. Most cases are mild and can be simply monitored until the child is done growing. In some cases, back braces and physical therapy can help support the spine and relieve symptoms. Due to effects to the spinal cord, kyphosis can sometimes cause neurological issues such as trouble walking, leg pain, and difficulty with bladder control. If surgery is needed, the most common treatment is spinal fusion surgery.
Congenital scoliosis is less common than other forms of scoliosis and occurs in just 1 in 10,000 U.S. births. While it is sometimes identified at birth, some instances of congenital scoliosis may not be discovered until the child goes through a growth spurt. Scoliosis is most often treated with a simple back brace, but severe cases may also require surgery. Moderate and severe cases of scoliosis can be painful, can damage the joints, and may even cause arthritis of the spine. Severe curves (more than 50 degrees) can even cause lung issues. Mild curves can simply be monitored throughout adolescence and adulthood to ensure that the condition doesn’t get worse or cause any other issues. Most children will go on to lead active and healthy lives with negligible effects.
Spina bifida is part of a category of neural tube defects that affects the spine. During fetal development, the spinal cord and its nerves do not develop properly. According to the CDC, it occurs in about 1 in every 2,758 births and is linked to low maternal levels of folic acid during pregnancy. Hispanic individuals are more likely to be affected by spina bifida.
Children born with spina bifida may have mild effects or more serious life-altering symptoms including weakness and paralysis. They may also deal with bowel and bladder issues or hydrocephalus. Diagnosis in some cases occurs before birth, but often, it is not found until after a baby is born.
Some children may need surgery to correct side effects like hydrocephalus, and others may need assistance walking with leg braces or using a wheelchair. Overall, most children with spina bifida are able to live active and happy lives.