Birth defects in Iraq and the plausibility of environmental exposure: A review

Birth defects are still the leading cause of perinatal mortality and childhood disability in developed countries [1]. In contrast, in some developing countries where infant mortality remains very high, the leading causes of death are related to malnutrition and infection [2]. However, birth defects in the developing world are largely underreported by deficiencies in diagnostic capabilities and lack of reliability of medical records and health statistics [3]. Thus, an increase in birth defects rate should be handled with caution as this could only be attributed to use of more reliable diagnostic facilities or an improvement in medical records.The causes of most birth defects remain unknown, but the growing literature indicates that environmental factors may cause genetic mutations and interact with genetic factors predisposing to birth defects [4]. Thus, most birth defects can be considered to be of multifactorial causation that is due to a combination of environmental and genetic factors. Prevalence studies of birth defects are useful to establish baseline rates, to document changes over time and to identify clues to etiology. They are also important for planning and evaluating antenatal screening for birth defects, particularly for high risk population [5].Workers allegedly reported a high prevalence of birth defects in Basrah (south of Iraq) in the post 1991 Gulf War period, which was attributed to exposure to depleted uranium (DU) used in the war [6,7]. This provided impetus for further research in this particular field in Iraq. This paper reviews the published literature and provided evidence concerning birth defects in Iraq to elucidate possible environmental exposure. The review also used some directly collected data on birth defects from Al-Ramadi Maternity and Paediatric Hospital in Al-Anbar Governorate in Iraq from1st July 2000 through 30th June 2002 where a total of 12831 live births and stillbirths at hospital were included. All live born neonates were ph