On World Birth Defects Day on March 3, the Pan American Health Organization (PAHO) is drawing attention to a leading cause of neonatal death and childhood disability in Latin America and the Caribbean. Thousands of families face diagnoses that require specialized care, continuous follow-up, and comprehensive support.
Pablo Durán, Regional Advisor on Perinatal and Neonatal Health at PAHO, said, “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—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,” Durán explained. “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.”
Durán said 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.” While not all are preventable, “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.”
He emphasized prevention, saying, “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.”
Among interventions with the strongest evidence, Durán highlighted “food fortification with folic acid, which has been shown to significantly reduce central nervous system birth defects, and vaccination against rubella, which prevents congenital rubella syndrome.” He noted that these measures, combined with epidemiological surveillance, screening and registry systems, and strengthened health systems, “are fundamental pillars for reducing the burden of these conditions.”
Durán also discussed PAHO’s Birth Defects Repository for the Americas, which consolidates data reported by national surveillance systems. “This tool improves comparability between countries, helps identify trends and gaps, and strengthens evidence-based decision-making,” he said. “Having timely, high-quality information is essential to guide resource allocation, plan services, and prioritize interventions—especially for conditions that can be treated after birth, such as certain congenital heart defects or neurometabolic disorders.”
Reflecting on the 2016–2017 Zika epidemic, Durán said, “The Zika epidemic highlighted the importance of having coordinated surveillance systems capable of detecting unusual increases in specific congenital anomalies at an early stage. Above all, it made clear that preventing birth defects linked to infectious diseases requires comprehensive approaches involving surveillance and response from entomological, laboratory, clinical, and community perspectives.”
On challenges in the Caribbean, he noted, “Significant challenges remain in terms of coverage, quality, and equity in access to neonatal screening and early diagnosis. Social, economic, and geographic gaps directly influence the timeliness of diagnosis and continuity of care.” He added that expanding screening coverage and ensuring access to specialized services remain priorities.
Under this year’s theme, “Every journey matters,” Durán said the key message is clear: “Every child, every family, and every life journey deserves support, respect, and access to quality services. Reducing the impact of birth defects means advancing prevention, early detection, and comprehensive care, with an equity-based and non-stigmatizing approach. Every journey matters because behind every diagnosis there is a story that deserves to be supported through strong public policies, strengthened health systems, and sustained commitment.”
