Thalidomide-associated birth defects in Brazil revealed

25 July 2013

The BBC has reported on new scientific research showing that birth defects due to the drug thalidomide are a persistent problem in Brazil.
Thalidomide is infamous for having caused severe limb malformations in the children of women prescribed the drug to combat morning sickness in pregnancy; it was withdrawn from use in the 1960s. This is a prime example of an environmental (as opposed to genetic) cause of birth defects.
However, thalidomide is an effective treatment for some conditions including leprosy, and was quickly relicensed for this purpose (with warnings prohibiting its use by women who could become pregnant) in countries such as Brazil, which has more than 30,000 new cases each year.
Professor Lavinia Schuler-Faccini of the Universidade Federal do Rio Grande do Sul led new research that has shown increasing numbers of Brazilian children being born with thalidomide-associated birth defects, provoking debate about balancing the widespread benefits for leprosy patients against the rare but severe risks to unborn children of the drug. Prof Schuler-Faccini, a fellow of the PHG Foundation and a key contributor to work developing their health needs assessment toolkit for congenital disorders said: "A tragedy is occurring in Brazil... it is a syndrome which is completely avoidable".

Comment: This work demonstrates the value of epidemiological research to identify the true number of cases of a given birth defect and potential causes for unexpected rates. Similarly, the toolkit uses existing data from around the world to help health professionals compare birth defects in their own region and identify potential causes and interventions. The best solution is not always obvious – in this case, there are competing health needs; often, resources are very limited – but understanding the true picture is essential in planning measures to improve prevention and care. 

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