By AJN clinical editor Betsy Todd, MPH, RN, CIC
Microcephaly has been in the news in recent months because of its possible link to Zika virus infection. Here in the U.S., an unusually high incidence of babies with anencephaly in the state of Washington has concerned health authorities for the past four years.
In the spring of 2012, several babies were born with anencephaly in three counties in south central Washington. This unusual cluster of cases, occurring at more than twice the national rate for anencephaly, was first recognized by nurse Sara Barron. She explores the state’s investigation in “Anencephaly: An Ongoing Investigation in Washington State” in the March issue of AJN.
Like microcephaly, anencephaly is a “neural tube defect” that leads to tragic pregnancy outcomes. In microcephaly, the baby’s brain has not developed properly and the head is smaller than expected. Anencephaly is even more severe: usually these babies are born without a skull or cerebral hemispheres, and most die within hours.
Case-control studies of anencephaly in Washington, along with previous studies exploring neural tube defects in general, point to several factors that may be associated with the development of such congenital malformations, including “folic acid deficit, genetic variants in the folate pathway, and exposure to a variety of environmental and occupational toxins.”
As of November 2015, cases of anencephaly in Washington State had continued to increase, with the current rate estimated at 9.5 per 10,000 live births. Read this month’s article to learn more.