In the past, the toll of birth defects in these countries has been underestimated for a variety of reasons, the report authors say. These include poor, if any, health statistics; lack of birth defects surveillance or registries; reliance on hospital-based, rather than population-based, studies; and limited diagnostic capability. Even with the sophisticated facilities available in wealthier nations, only about 50 percent of birth defects can be diagnosed accurately, the report authors say.
Just one of those causes, fetal alcohol syndrome (mental and physical defects caused by drinking alcohol during pregnancy), is a "huge problem but there are countries that don't recognize or monitor it," Prof. Christianson says. "Around the world, fetal alcohol syndrome is one of the more common fetal environmental problems."
Professor Modell has worked for many years to develop the database, using all information available and extrapolating, based on known experience in other countries, to fill in gaps. "This is a first cut," she says. "With more study and more money, we will be able to answer many of the questions that this report has uncovered."
Data provided for the first time in this report are considered an essential addition to the extensive worldwide effort to reduce infant and child mortality to meet one of the United Nations Millennium Development Goals for 2015. By the beginning of 2004, efforts to meet this goal fell far below U.N. projections. Data in the March of Dimes report make a strong argument for recognizing and addressing the significant contribution of birth defects to infant and childhood mortality if the U.N. goal is to be achieved.