
Editorial: Innovative ResearchBirth
defect rates are climbing. Of 38 birth defects monitored by the Centers for Disease
Control and Prevention (CDC), 27 (71 percent) were more frequent in 1989 than a decade
earlier. Only two decreased in the same interval, and the figures for the remainder were
depressingly stagnant.
A bright spot has come from researchers carefully studying human populations to track
down the causes of these defects. The discovery that folic acid helps prevent neural tube
defects, such as spina bifida, began with the observation that these defects are common in
areas where diets are low in folic acid, and was proven in tests showing the benefits of
folic acid in human beings.
A new and stunning breakthrough has emerged in research on cerebral palsy and mental
retardation. It began when researchers at the CDC set out to identify why some very
low-birth-weight infants develop these conditions while others do not. They found that if
the infants mothers had a preeclampsia, a syndrome of high blood pressure late in
pregnancy, there was much less risk of brain hemorrhages in their babies that can lead to
brain damage. As they studied the mothers and infants, it became clear that what was
protecting the babies was not their mothers preeclampsia, but the magnesium sulfate
used to treat it. When women received magnesium sulfate, the risk of brain injury in their
infants was dramatically reduced.
The researchers then looked at other cases where magnesium was given during pregnancy.
Indeed, statistics show that magnesium could potentially prevent 63 percent of cases of
cerebral palsy and 49 percent of cases of mental retardation.
Diana Schendel, Ph.D., is leading this vital research, and is the winner of PCRMs
Research Innovation Award for 1998. Dr. Schendel completed her graduate studies at
Pennsylvania State University and specializes in developmental disabilities. As an Acting
Section Chief in the CDCs Division of Birth Defects and Developmental Disabilities,
she recognized the enormous potential importance of studies in magnesium and set about to
gather the essential data in at-risk human populations to help clinicians prevent
devastating birth defects.
Her research was funded by the U.S. government. Conspicuously absent from this effort
was the March of Dimes, the wealthiest private charity in the birth defects arena. Its
fund-raising walks have brought in more than $700 million over the years, but its research
projects remain under fire for their lack of applicability and their continuing focus on
animals, rather than on tracking down the causes of human birth defects. More progressive
charities, such as the Association of Birth Defect Children, have been working to redirect
efforts toward elucidating the causes of birth defects in human populations.
Dr. Schendels work is an admirable example of the kind of effort of which we need
much more. We thank her and her team for their dedication and vision.
Neal Barnard, M.D.
President of PCRM
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