Cluster of birth defects needs more study

It has been three years since a nurse alerted state health officials to an alarming coincidence she saw at Prosser Memorial Hospital, and questions surrounding those circumstances still remain.

Sara Barron, who was in charge of infection control and quality assurance at the hospital in 2012, noticed that two babies born just weeks apart had a rare birth defect called anencephaly. It is a fatal condition in which a baby’s neural tube, which forms the brain and spinal cord, fails to close early in a woman’s pregnancy. These babies typically die shortly after birth.

Barron’s concern set off alarm bells, and led to a state investigation that ultimately found more than 40 mothers in Yakima, Benton and Franklin counties had given birth to babies with anencephaly since 2010. That rate is five times higher than the national average.

No cause for this birth defect cluster was ever found, but interest in these cases has been renewed after a recent Seattle Times report suggested the research that was conducted so far is not as thorough as it should have been.

A study led by the state Department of Health showed that 23 cases were found in the three counties from January 2010 through January 2013. The rate continued to climb, and Washington state health officials launched another investigation in June 2014 tapping a 16-member advisory panel. They analyzed existing reports of nitrate levels in drinking water and pesticides used on farms in the region.

But the Times report noted that not all the women who lost babies to anencephaly had been contacted, and health officials had not conducted tests that could possibly lead to a genetic or environmental connection among the women involved. Panel officials have said they have been trying their best, according to the Times report.

But while health officials do what they can with the resources they have, we are still left without answers. And it’s troubling.

One positive change has happened, however, and that is more low-income women should be able to get folic acid through the state’s health system.

Not getting enough folic acid before and during the early stages of pregnancy is known to increase the risk of babies born with neural tube deformities, but the state Medicaid program had been limiting women’s access to the free supplement. Now, after the Times questioned the policy, all women of childbearing age enrolled in the state’s Apple Health plan are encouraged to take folic acid, not just those who are already pregnant.

This is a good step, but it should have been taken long ago.

While there is no doubt that research can take time — and trying to find a common factor that can link all these cases together is certainly no easy task — we hope state health officials will keep a watchful eye and continue gathering data.

A birth defect cluster such as this cries out for continued research. Until all possible leads are followed, the investigation should continue.

This story was originally published December 21, 2015 at 4:57 PM with the headline "Cluster of birth defects needs more study."