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Millions of serious birth defects, mostly in developing countries, could be avoided with cheap and simple measures, says a report released today (31 January).

The report, by the US-based charity March of Dimes, is the first detailed global study of the problem.

It says more than eight million children are born with serious diseases caused by their genes or by environmental factors every year, with 94 per cent of all birth defects occurring in low and middle-income countries.

The most common defects include deformities of the heart or spine, and blood disorders such as thalassaemia.

The report says about 3.3 million children die from birth defects each year while another 3.2 million endure severe disabilities. But simple, cost-effective approaches could cut these deaths and disabilities by up to 70 per cent, it adds.

According to the report, 15 of the 22 countries with the most birth defects are in the Middle East and North Africa.

Co-author Bernadette Modell of University College London, United Kingdom, says this is partly due to poor maternal nutrition, the high prevalence of inherited blood disorders such as sickle cell disease and thalassaemia, and because blood relatives often marry — increasing the chance of genetic diseases in their children.

The report says folic acid supplements, iodised salt, and immunisation against rubella are among the cheap solutions that could vastly reduce the number of birth defects in developing countries.

It also says these countries should create maternal and child health programmes to raise awareness among health workers, policymakers and the public about the causes of birth defects and ways of preventing or treating them.

"I fully agree with the main message: birth defects can be prevented," says Pierpaolo Mastroiacovo, director of the Italy-based International Clearinghouse for Birth Defects Surveillance and Research.

"The starting point is an efficient birth-defects surveillance programme implemented even in a small area or in a few maternity hospitals," he said, adding that his organisation could help set up such programmes.

According to the report, Sudan has the most birth defects, with 82 per 1,000 live births, compared with 39.7 in France, which had the lowest number among the 193 countries surveyed.

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