Rising numbers of birth defects in parts of China have sparked a debate on the resumption of compulsory pre-marital health checks and calls for more research into the causes.
Figures released by Zhejiang and Guangdong provinces in advance of the publication of national figures by the Ministry of Health next week show alarming rises in the number of birth defects.
In Zhejiang, the incidence of babies with birth defects was 1.15 percent in 2003 -- the year compulsory pre-marital health checks were scrapped -- rising to 1.33 percent in 2004 and 1.47 percent last year.
About 480,000 babies are born in Zhejiang each year, which means about 7,200 babies were born with defects in 2005.
In the southern province of Guangdong, the incidence has risen from 0.96 percent ten years ago to 2.12 percent today.
In Shanghai, birth defects have been reported as the top killer of babies for the past 10 years.
Cleft palette, neural tube defects, hyperdactylia (excessive numbers of fingers or toes), congenital heart disease and hydrocephalus (water on the brain) are the top five birth defects among Chinese babies.
Experts said hereditary diseases, viral infections, environmental pollution, unhealthy lifestyles and poor nutrition were among the main known causes.
Duan Tao, deputy head of the No. 1 Maternity and Children Care Center affiliated to the Tongji University in Shanghai, said the treatment of chronic diseases, the prohibition of marriage between close relatives and discouraging pregnant women from drinking alcohol and smoking could help reduce birth defects.
Pre-marital tests could also prevent the transmission of hereditary diseases and pre-pregnancy health checks could detect viruses that caused birth defects, said Gu Peibao, an obstetrician at Zhejiang Maternal and Children Health Hospital.
"Some would-be parents pay more attention to smoking and drinking and even avoid living in newly-renovated apartments, but forget or ignore pre-marital tests," Gu said.
The number of would-be couples undergoing the checks has dropped drastically since they were made optional in 2003, after previously being a legal prerequisite for obtaining a marriage license.
Pan Guiyu, deputy director of the State Population and Family Planning Commission, called for the resumption of compulsory pre-marital tests, saying their cancellation in 2003 was a major cause of the rise in birth detects and could affect the "quality" of the population.
To reverse the situation, some local health authorities have begun providing free pre-marital tests to encourage more people to go through the health check, but the outcome was not promising.
However, some experts argued it was uncertain if lack of pre-marital tests had significantly contributed to the rising incidence of birth defects.
"Currently we have no concise figures to support this claim, so the resumption of compulsory pre-marital tests needs more consideration," said Ma Huaide, professor of the China University of Political Science and Law, in an interview with major Chinese Internet portal Sina.com.
According to professor Wang Yifei, of the Shanghai Jiaotong University, 50 to 60 percent of birth defects in humans occurred for no obvious reason.
Chromosomal abnormality contributed to six to seven percent, genetic mutation contributed seven to eight percent, environmental factors seven to 10 percent and the comprehensive effect of hereditary and environmental factors 20 to 25 percent, according to a research revealed by Wang.
He called for the establishment of a monitoring system on birth defects in China linked with international network, while stepping up research on hereditary and environmental factors.
China has about one million to 1.2 million babies born with defects each year, accounting for four to six percent of births, latest official figures show.
Birth defects, also called congenital anomalies, are a major cause of infant mortality and childhood morbidity, affecting two to three percent of all babies around the globe, according to the World Health Organization.
In countries where infant mortality has been reduced to less than 50 per 1,000 births, birth defects are emerging as the most common cause of neonatal deaths. These deaths account for 30 to 50 percent of perinatal mortality and 20 to 30 percent of infant mortality, according to figures released at the second International Conference on Birth Defects and Disabilities in the Developing World held in September 2005.
Reducing mortality by two-thirds among children under five has been set by the United Nations as one of the eight Millennium Development Goals, all 191 U.N. member nations have agreed to meet this goal by 2015.