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9003: Study Reveals More Haitian Birth Defects (fwd)

From: leonie hermantin <lhermantin@hotmail.com>

Study Reveals more Haitian Birth Defects

By Bob LaMendola
Health Writer

A baby born to a Haitian mother in Florida is more likely to suffer from 
birth defects than babies in other ethnic groups, prompting Haitian 
activists to call for better prenatal education.

Some of the most debilitating birth defects appear in Haitians two or three 
times more often than average, the Fort Lauderdale group Minority 
Development & Empowerment said in a new research paper.

“Many of these are preventable with simple things, like vitamins, exercise, 
diet, how you treat yourself,” said Marvin Dejean, the group’s senior vice 
president. “But many Haitian women are not exposed to that information.”

No one knows why the rates are higher for Haitians, but issues of poverty, 
health insurance, education, diet and exercise probably account for most or 
some of the disparity, the group’s researchers said.

The disparity has long been suspected, but now is borne out by statistics 
that the group compiled from the state-funded Florida Birth Defects 
Registry, which issued its first report last year.

Heart problems

Of 4,780 Haitian babies born in 1996, at least 166 birth defects were found. 
Haitians had the highest rates in 13 of 27 defects studied by the Fort 
Lauderdale group, including certain heart defects, Down syndrome and 
undersized craniums.

By comparison, whites were highest in three birth defects, African-Americans 
in four, Puerto Ricans in five and Cubans in two.

Some of the differences may be due to genetic factors that cannot be 

But the group’s leaders said the disparity suggests that the Florida 
Department of Health, county social service agencies and the March of Dimes 
ought to target Haitian women with culturally tailored education on 
preventing birth defects.

Haitians have been counted among African-Americans when devising programs to 
educate pregnant women, but the group said its numbers show that each ethnic 
group is beset by different birth defects and needs a tailored approach.

Pattern of defects

Spina bifida (incomplete closure of spine) and malformed penises most often 
strikes whites. Cleft palate and certain heart defects are most prevalent in 
Puerto Ricans. Water on the brain and certain heart valve problems are most 
prevalent in African-Americans. Certain eye and urinary defects are most 
prevalent in Cubans.

“To lump [ethnic] groups together is unconscionable,” said Leonard Fontana, 
a Parkland researcher who made the study along with Adele Beckerman, an 
education professor at Nova Southeastern University.

Vitamin advantage

The researchers said a 1999 survey of 459 pregnant women in Broward County 
sheds light on why Haitian babies have more birth defects.

The 81 Haitian mothers in the survey were less likely than others to know 
that the B vitamin folic acid (folate) can prevent 80 percent of spinal cord 
and brain defects.

Barely half of women in any ethnic group knew about folic acid.

The vitamin is plentiful in orange juice, green leafy vegetables, beans, 
peas and fortified bread and grain products. A daily multivitamin with 0.4 
mg (400 micrograms) of folic acid does the trick, nutritionists say.

Women often do not take vitamins until they know they are pregnant, but some 
birth defects happen within the first weeks, said Virginia Carver, a 
University of Miami genetics specialist who works with pregnant women.

“Even when they know, people are not compliant,” said Carver, who works on 
the birth defects registry. “We still need a great deal of effort.”

In the survey, Haitian women were more likely to gain more than 40 pounds or 
less than 10 pounds during pregnancy, more likely to skip meals, less likely 
to exercise and less likely to eat better while pregnant. All those factors 
raise the risk of problems.

Folkloric methods

Haitian women are less likely to have jobs and health insurance, so they 
tend to follow traditional, folkloric methods rather than get prenatal 
doctor’s care, Dejean said.

Told about the group’s study, a March of Dimes spokeswoman agreed that more 
and smarter efforts to reach Haitian women would be worth considering. The 
organization has started a national campaign aimed at Latinas, but none of 
its programs or materials are done in Creole.

“We don’t really do anything now that is targeted to Haitians,” said 
Rochelle Darman, spokeswoman for the March of Dimes in southern Florida. “We 
know there is disparity among the ethnicities. We’re trying to help 
eliminate them.”

Haitian physicians may need to do more to stress birth defects prevention to 
their patients, said Dr. Joseph Fanfan, a Fort Lauderdale family 
practitioner. He plans to raise the question with the 250 doctors in the 
southern Florida chapter of the Haitian Medical Association Abroad.

“I do bring it up with my patients,” Fanfan said. “But saying it once to 
somebody whose health education has not been strong before may not be 
enough. It takes a reinforcement of the message. We need programs.”

County health departments have Creole-speaking nurses at clinics and do 
offer folic acid, but do not have programs focused on birth defects, said 
Deborah Hill, nursing chief at the Broward department.

Guatemalans targeted

In Palm Beach County, high rates of birth defects among Guatemalan 
farmworkers exposed to pesticides led to the creation of the birth defects 
registry and sparked programs targeting them.

Healthy Mothers, Healthy Babies of Palm Beach found that Guatemalan women 
responded best to cassette tapes and videos at a community center and health 
department clinics, said Kathy Cohn, the group’s president. Nothing exists 
for Creole speakers, she said, but it may be a good idea.

Bob LaMendola can be reached at blamendola@sun-sentinel.com or 954-356-4526.
Copyright © 2001, South Florida Sun-Sentinel

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