Every year, over one in 33 babies born in the United States, arrives with a birth defect, a leading cause of infant mortality. Although much of the risk is due to genes and unidentified environmental causes, a new Centers for Disease Control and Prevention (CDC) study identifies a number of modifiable risk factors that operate among most women under age 50. The findings, published in the American Journal of Preventive Medicine, emphasize targeted public health measures and individual lifestyle decisions in lowering the risk for major birth defects.

The CDC study examined data from 5,374 women between ages 12 and 49 who took part in the National Health and Nutrition Examination Survey between 2007 and 2020. Scientists zeroed in on five major risk factors that can be treated before or during pregnancy: obesity, diabetes, tobacco exposure, food insecurity, and low folate levels.

The findings were dramatic. Almost 66% of the interviewed women possessed at least one of these risk factors, and 10% possessed three or more. Obesity had impacted approximately one-third of women, and around five percent had diabetes. Almost 20% were exposed to tobacco smoking, vaping, or second-hand inhalation. Food insecurity, which impacts nutritional intake as well as access to prenatal vitamins, had affected around seven percent of women. Most alarming, 80 percent of women lacked folate, or vitamin B9, a key nutrient in fetal development.

The Role of Folate and Prenatal Nutrition in Women

Folate is also crucial to DNA synthesis, cell growth, and red blood cell production. During early pregnancy, lack of folate can interfere with neural tube formation, resulting in neural tube defects like spina bifida and anencephaly. The FDA has required folic acid fortification in enriched cereal-grain food since 1998, reducing the number of neural tube defects by an estimated 1,300 cases per year.

Even after fortification, the CDC study showed that almost eight out of ten women were still below the 400 micrograms (mcg) of folic acid per day, even after supplement use. Only 13% were at the recommended daily dose, leaving millions of women at increased risk of avoidable birth defects. Natural foods that are good sources of folate, like leafy green vegetables, legumes, asparagus, avocados, broccoli, and fortified cereals, are still imperative to a balanced diet.

Are Obesity and Diabetes The Hidden Threats Prior to Pregnancy?

Obesity and diabetes became prominent factors in high risk. Both conditions can disrupt metabolism of nutrients, such as folate, and increase the risk of congenital heart defects, neural tube defects, and orofacial malformations in the fetal fetus. Obesity occurs in one-third of women of childbearing age, and close to five percent have diabetes, which includes undiagnosed or uncontrolled diabetes.

Controlling these conditions with diet, physical activity, and blood sugar testing is an important part of preconception care. As the CDC's Dr. Wang said, "The risks can be reduced through measures such as taking the recommended 400 micrograms of folic acid every day, eating a good diet, exercise, and controlling blood sugar."

How Tobacco Exposure and Smoking Affect Infant Health?

Both active and passive tobacco exposure causes the introduction of toxins that raise oxidative stress and compromise nutrient intake. Almost 20% of the women studied had raised serum cotinine levels, indicating tobacco exposure. Previous studies have associated maternal smoking with preterm delivery, birth weight, stillbirth, and Sudden Infant Death Syndrome (SIDS).

Food insecurity adds to these risks. Approximately seven percent of women indicated a severe problem in accessing healthy food. Malnutrition in the mother can lead to deficiencies in important nutrients, including folate, and can increase the risk of obesity or metabolic disease in the child as an adult. Restricted availability of prenatal supplements also adds to these risks, especially in low-income groups.

How Lifestyle Risk Factors Increase Over Time?

The CDC analysis also showed dramatic disparities. Although risk factors were less common among teens and young women in their early twenties, almost three-quarters of women 35 to 49 years old had at least one risk factor. Non-Hispanic Black women had the most burden, with 80% having at least one risk factor, followed by 62% of non-Hispanic White women. Economic status was another predictor, with lower-income women having more than one risk factor, such as food insecurity and low folate status.

These disparities point to the importance of targeted interventions, such as affordable nutrition programs, smoking cessation programs, and preconception counseling, especially in communities with systemic barriers to healthcare.

What Is Causing Birth Defects During Pregnancy?

Although causes of the majority of birth defects continue to be multifactorial, researchers typically cite a combination of genetics, environmental exposures, and maternal health as the culprits. Approximately 25% of defects are caused by chromosomal or genetic anomalies, such as Down syndrome. Environmental conditions, such as infection, diabetes in the mother, inadequate nutrition, and particular medications, are responsible for approximately five to ten percent. The other 65% are thought to be caused by intricate or unexplained interactions between genetic risks and the environment.

Obesity, diabetes, smoking, and folate deficiency can interfere with vital biological processes, such as the one-carbon cycle, which utilizes nutrients such as folate, vitamin B12, and choline to control DNA synthesis and cell division. If this cycle does not work, the development of the brain and spinal cord in the fetus can be impaired.

Easy Steps Women Can Take to Reduce the Risks of Birth Defects During Pregnancy

Prevention is fundamental. Women preparing for pregnancy need to achieve a healthy weight, control blood sugar, not use tobacco, have regular intake of folic acid supplements, and eat well-balanced diet with high natural sources of folate. Public health initiatives that enhance access to healthy food and prenatal supplements are important, especially for women experiencing food insecurity.

Health care professionals are responsible for risk factor screening, preconception counseling, and informing women of salutary measures to maximize fetal health. Even small changes in lifestyle, i.e., better nutrition, regular physical exercise, and the use of folic acid supplements, can decrease significantly the risk of severe birth defects.

Birth defects occur in one of every 33 babies and are the cause of about 20% of infant mortality. They may be mild, like clubfoot or webbed feet, to life-threatening and severe, like anencephaly or Trisomy 13. Although genetics cannot be changed, the CDC report highlights that most women have modifiable risk factors that, when corrected, can reduce the risk of complications.

Dr. Wang stresses, "Every expecting family wishes for a healthy baby and healthy pregnancy. When families and their healthcare providers understand the modifiable risk factors for birth defects, they can make data-driven choices that may result in healthier babies and pregnancies."

For centuries, historians and scientists have debated what exactly triggered the Justinian Plague, a catastrophic pandemic that began in 541 AD and ravaged the Byzantine Empire for over two centuries. There were so many theories and guesses but hard biological proof was always missing. Now, the researchers dug into a mass grave in Jerash, an ancient Roman city in present-day Jordan, and uncovered the genetic pathogen: Yersinia pestis, the bacterium infamous for causing plague.

The discovery, published in the journal Genes, finally ties the Justinian Plague to the same microbe that would later fuel the Black Death in mediaeval Europe.

As Dr Rays HY Jiang from the University of South Florida summed up, "This discovery provides the long-sought definitive proof of Y pestis at the epicentre of the Plague of Justinian."

What Was the Justinian Plague?

If you think Covid-19 was disruptive, imagine a pandemic that stretched across centuries. Between 541 and 750 AD, the Justinian Plague killed tens of millions, weakened armies, wrecked economies, and reshaped the Byzantine Empire.

It first appeared in Pelusium, an Egyptian port city, before sweeping through the Eastern Roman Empire like wildfire. The sheer scale of death was so staggering that some historians argue it permanently altered the course of European history. And yet, until recently, no one could prove with certainty what caused it.

“For centuries, we have relied on written accounts describing a devastating disease but lacked any hard biological evidence of the plague's presence. Our findings provide the missing piece of that puzzle,” Dr Jiang explained.

Digging Up the Past, Tooth by Tooth

Archaeologists excavated burial chambers beneath Jerash’s former Roman hippodrome—a structure once used for chariot races and grand public spectacles. There, they discovered human remains from victims of the plague.

"Using targeted ancient DNA techniques, we successfully recovered and sequenced genetic material from eight human teeth excavated from burial chambers beneath the former Roman hippodrome in Jerash, a city just 200 miles from ancient Pelusium,” said Greg O'Corry-Crowe, another author of the study.

The analysis revealed nearly identical strains of Yersinia pestis, meaning the outbreak spread quickly and with devastating impact, just as historical texts described.

From Entertainment Hub to Emergency Cemetery

What makes Jerash especially symbolic is its transformation during the crisis. Once a buzzing trade hub with impressive Roman structures, it suddenly became a burial site.

"Jerash was one of the key cities of the Eastern Roman Empire, a documented trade hub with magnificent structures,” Dr Jiang said.

“That a venue once built for entertainment and civic pride became a mass cemetery in a time of emergency shows how urban centres were very likely overwhelmed.”

It is a sobering reminder of how pandemics can flip the world upside down, turning arenas of joy into sites of despair.

Lessons That Still Matter Today

The Justinian Plague may feel like ancient history, but its echoes reach into our present. Plague has not disappeared; it lingers quietly in the background, occasionally resurfacing.

"We have been wrestling with plague for a few thousand years, and people still die from it today," said Dr Jiang. "Like Covid, it continues to evolve, and containment measures evidently cannot get rid of it. We have to be careful, but the threat will never go away.”

That statement might sound chilling, but it is also a reminder: disease, no matter how old, never truly leaves us. The more we learn from ancient outbreaks, the better prepared we are to face future ones.

What Now?

By decoding the genome of Yersinia pestis from the Justinian era, scientists can better understand how the bacterium has evolved and survived across millennia. It also points out how pandemics have always shaped societies—toppling empires, shifting populations, and altering human history.

For nearly three decades, the Foodborne Diseases Active Surveillance Network—better known as FoodNet—has been a cornerstone of food safety monitoring in the United States. Established in the 1990s, the system actively tracked laboratory-confirmed cases of foodborne infections across 10 states, covering more than 50 million Americans. It was widely regarded as the most reliable source of data on how foodborne pathogens affect people in real time.

But in July, the Centers for Disease Control and Prevention (CDC) made a dramatic change that caught even public health experts off guard. FoodNet, which once monitored eight of the most common foodborne pathogens, will now actively track only two: Salmonella and Shiga toxin-producing E. coli (STEC). Monitoring of the other six pathogens—Campylobacter, Cyclospora, Listeria, Shigella, Vibrio, and Yersinia—has been cut from the system’s required surveillance.

The CDC has defended the move as a resource-driven necessity, but food safety officials warn the implications could be far-reaching.

What the CDC Isn’t Tracking Foodborne Illnesses Anymore?

The CDC has stated that the decision was rooted in funding limitations. In a memo shared with the Connecticut Department of Health, the agency wrote: “Funding has not kept pace with the resources required to maintain the continuation of FoodNet surveillance for all eight pathogens.”

CDC spokesperson Paul Prince echoed this sentiment in a statement, narrowing surveillance would allow FoodNet staff “to prioritize core activities” and “steward resources effectively.”

The backdrop of the decision is years of budgetary tightening. Under the Trump administration, the CDC and other federal agencies faced significant cuts, with the CDC losing hundreds of employees in a single year. While the agency still maintains other surveillance programs—including the National Notifiable Diseases Surveillance System and the Listeria Initiative—those systems are passive. Unlike FoodNet, which actively gathered case information from hospitals and laboratories, passive systems depend on health departments voluntarily reporting infections.

FoodNet was unique in its reach and approach. Operating in 10 states—Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, Oregon, Tennessee, and select counties in California and New York—the program didn’t simply count cases. It collected detailed data about each infection, including patient demographics, hospitalization rates, and outcomes. This level of detail allowed scientists to track trends, spot outbreaks early, and identify which foods posed the greatest risks.

With six pathogens now off the mandatory list, experts worry the CDC is losing its clearest lens into the country’s food safety picture.

“FoodNet doesn’t just count cases,” explained Carlota Medus, who supervises the Minnesota Department of Health’s foodborne diseases unit. “The FoodNet sites collect robust data that contribute to the understanding of certain infections. Without that, we’ll miss trends and lose the ability to compare data over time.”

Other Pathogens That May Go Unnoticed

Salmonella and STEC are among the leading causes of severe foodborne illness, accounting for significant numbers of hospitalizations and deaths each year. But the other six pathogens removed from FoodNet’s core surveillance aren’t minor players.

1. Campylobacter is one of the most common bacterial causes of diarrhea worldwide.
2. Listeria is especially dangerous for pregnant women, newborns, and immunocompromised individuals, often leading to life-threatening infections.
3. Cyclospora has been behind large outbreaks linked to imported produce.
4. Vibrio infections are increasingly common as warming waters fuel bacterial growth in seafood.
5. Shigella and Yersinia also cause serious illness, particularly in children.

By removing active surveillance of these pathogens, public health agencies may not immediately detect upticks in infections—or worse, may not realize when an outbreak is underway until it spreads widely.

What Are The Risks of Passive Food Safety Monitoring?

Foodborne infections are legally reportable in the U.S., but passive reporting systems depend heavily on overwhelmed local health departments. Without the active case-finding that FoodNet provided, some infections may never be logged.

This shift doesn’t just risk slower outbreak detection; it also undermines years of carefully built datasets. Tracking trends over time requires consistency. If monitoring drops for certain pathogens, comparing future case numbers to historical data becomes nearly impossible.

Medus warned that “long term, it will affect our ability to use surveillance data to better understand risks in the food supply.” That data, she noted, has historically been critical in shaping both state and federal food safety policies.

The White House has insisted that food safety remains a top priority. A spokesperson for the administration said in a statement: “The health and safety of the American people is the Administration’s utmost priority. USDA, HHS, FDA, and the CDC will continue to cooperate and maintain the highest vigilance to safeguard our food supply against pathogens.”

Still, the quiet rollout of the change with no public announcement until uncovered by NBC News—has left many food safety experts uneasy. Transparency is key in public health, and the perception of cuts without clear communication erodes public trust.

How Consumers Can Protect Themselves Despite the Cutbacks?

For the average consumer, the change won’t alter day-to-day food safety advice. Washing produce, cooking meat to safe temperatures, avoiding unpasteurized dairy, and practicing good kitchen hygiene remain the best defenses against foodborne illness.

But behind the scenes, fewer eyes on potential threats may mean outbreaks are detected later and policy shifts are slower to emerge. The U.S. already sees an estimated 48 million cases of foodborne illness each year, leading to 128,000 hospitalizations and 3,000 deaths, according to the CDC. Without robust surveillance, those numbers could be harder to track—or worse, to reduce.

What This Means for Food Safety Policy?

The cut to FoodNet highlights a deeper issue, foodborne illness surveillance is underfunded despite being essential. Experts argue that instead of scaling back, the U.S. should be expanding monitoring to capture new and emerging pathogens, especially as globalization and climate change reshape the food supply.

For now, FoodNet’s infrastructure remains intact, and states are free to continue monitoring other pathogens on their own if they have the resources. But state health departments often rely on federal funding to support surveillance staff. Without it, few will be able to maintain the same level of vigilance.

The White House has fired the director of the US Centers for Disease Control and Prevention (CDC), Susan Monarez. The White House stated that Monarez was "not aligned with the president's agenda." Her firing has created a lot of controversy. Monarez's lawyers quickly responded, saying she was not told about her removal and would not quit her job. They accused Health Secretary Robert F. Kennedy Jr. of targeting her because she refused to approve "unscientific, reckless directives." They also claimed Kennedy was "weaponizing public health."

Monarez is a scientist who specializes in infectious disease research. President Donald Trump nominated her, and she was confirmed by the Senate in July. She was the first CDC director in 50 years to not have a medical degree

What Are The New COVID-19 Vaccine Guidelines?

On the same day Monarez was fired, the Food and Drug Administration (FDA) approved new COVID-19 vaccines but with strict rules about who can get them. The vaccines will be available for all seniors, but not for younger adults and children who do not have other health problems. Health Secretary Kennedy commented on this, saying that the broad vaccine rules from the previous administration have now been "rescinded," or taken back.

Monarez's firing is just one part of the problems at the CDC. Earlier this month, a union for CDC employees announced that about 600 workers had been fired. The people who lost their jobs worked on important topics like infectious diseases and environmental hazards. In addition, Monarez had recently been comforting staff after a gunman, who believed he was harmed by COVID-19 vaccines, attacked the CDC headquarters and killed a police officer.

Will COVID Vaccines Come To An End?

There have also been reports that the Trump administration might get rid of COVID-19 vaccines completely. Health Secretary Kennedy, who is well-known for being skeptical of vaccines, has already made a big move by pulling $500 million in federal funding from 22 projects that were developing new mRNA vaccines. He said these vaccines don't work well against respiratory infections. However, medical experts say his claims are false and that his actions could make people lose trust in science.

HHS has also announced a big change in how it invests in vaccine research. The department is moving away from funding mRNA vaccine projects and is instead focusing on what it calls "alternative" vaccine technologies. This shift has drawn criticism from scientists who say that mRNA technology was crucial to the rapid COVID-19 response and is a vital tool for fighting future pandemics.

Another major change was when Kennedy got rid of every member of the Advisory Committee on Immunization Practices (ACIP). This group had been advising the CDC for decades. Kennedy replaced them with a small, hand-picked group, claiming the old members had conflicts of interest. These changes have made many medical professionals confused and concerned. Some clinics and pharmacies are now unsure whether to offer certain vaccines to pregnant women or healthy children, and they don't know if insurance will cover them. While older people and those with health problems can still get vaccines, access has become less clear for healthy children and adults.