Today marks World Birth Defects Day, an opportunity to raise awareness about a group of conditions that remain one of the leading causes of neonatal mortality and childhood disability in the Region of the Americas. Although many can be prevented or treated, thousands of families each year face diagnoses that require specialized care, continuous follow-up, and comprehensive support.
Under this year’s theme, “Every journey matters,” we are highlighting that these conditions affect not only those born with them, but also their families and communities, and underscores the importance of strengthening prevention and timely access to quality health services.
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In this interview, Pablo Durán, Regional Advisor on Perinatal and Neonatal Health at the Pan American Health Organization (PAHO), shares reflections on persistent challenges, the interventions that have shown the greatest impact in the region, and the actions needed to reduce the impact of birth defects through an equity-based, non-stigmatizing approach.
Why do birth defects remain one of the leading causes of neonatal mortality in the Americas, despite progress in child health?
Although the Region of the Americas has made significant progress in reducing neonatal mortality—from 12.9 deaths per 1,000 live births in 2000 to 7.1 in 2023, according to PAHO and UN data—deaths due to congenital malformations have not declined at the same pace.
Today we know that more than 20,000 newborns die each year from birth defects in the Region, and that nearly 22% of deaths in the first month of life are associated with these conditions. As we gain control over other preventable causes, such as infections or complications during childbirth, congenital anomalies account for a greater relative share of neonatal mortality.
What explains this gap?
The gap can be explained by several factors. The interventions that reduced other causes of neonatal and childhood mortality—such as improvements in nutritional status, infection control, prenatal and delivery care, and vaccination—are specific, relatively simple, and cost-effective actions.
In contrast, preventing and addressing birth defects requires more complex and sustained interventions across the life course: before pregnancy, during gestation, and after birth. It involves actions related to health, nutrition, the environment, and access to specialized services.
In addition, inequalities persist in access to prevention, early diagnosis, and specialized care. We also continue to face challenges in surveillance systems, which makes it difficult to fully measure the problem and design more precise responses. Many of these conditions have multiple—and in some cases unknown—causes, making prevention and reduction more complex.
What are the most common causes of birth defects in our region, and which are preventable?
The causes are multiple. They include genetic factors, nutritional deficiencies—such as lack of folic acid—infections during pregnancy such as rubella and Zika virus, as well as environmental exposures.
Not all are preventable, but a significant number can be avoided or mitigated through effective public health interventions, especially those related to proper nutrition, vaccination, and the prevention of infections during pregnancy.
That is why it is essential to strengthen access and quality care before and during pregnancy. Prevention begins even before conception, with information, family planning, and appropriate health check-ups that allow for early action.
