Pregnancy and Childhood Disabilities: What to Know, What to Do

Pregnancy is an exciting time, but it often comes with questions — especially about your baby’s health. The good news? A healthy pregnancy and good prenatal care can reduce many risks. But it’s also true that some childhood disabilities are influenced by things completely outside any parent’s control.

Experts stress a warm, non-blaming approach. As Malaysia’s Health Minister Dr. Dzulkefly Ahmad said:

“This program… shall be further enhanced… to prevent all infections that pass from mother to child.”

Translation? Malaysia has worked hard to catch and treat infections (like HIV and syphilis) in pregnancy so babies can have an HIV-free, healthy start in life.

Even with the best care, though, genetic or random factors can cause birth differences. For example, genetic conditions like Down syndrome or cystic fibrosis are present at birth due to changes in genes — not because of anything the parents did or didn’t do. As the CDC puts it:

“Not all birth defects can be prevented,”but healthy behaviours can help lower the chances.

How Pregnancy-Related Factors May Influence Childhood Disability

Below, we break down how different pregnancy-related factors — including infections, nutrition, substance use, maternal health, and prematurity — may influence four main categories of childhood disability: physical, intellectual, sensory, and developmental.

We also highlight expert advice and the Malaysian context, where possible. One important reminder: pregnancy is only one piece of the puzzle. Many disabilities also arise from genetics or postnatal events, and many are not preventable.

Types of Childhood Disabilities

Physical disabilities: Conditions like cerebral palsy (motor control issues from early brain injury), spina bifida (spinal cord defects), limb differences, and congenital heart defects fall under this category. Infections during pregnancy, like rubella or CMV, can cause heart or limb abnormalities.

Intellectual disabilities: These involve limitations in thinking, learning or reasoning. Causes include genetic conditions, brain injuries, lack of oxygen at birth, or infections during pregnancy that affect brain development.

Sensory disabilities: This includes hearing or vision loss. Congenital infections — especially CMV or rubella — are common causes. In the U.S., hearing loss from CMV is one of the most common developmental disabilities linked to pregnancy infections.

Neurodevelopmental disorders: These include autism spectrum disorder (ASD), ADHD, learning disabilities, and behavioural conditions. They relate to how the brain forms and functions. Maternal infections, poor nutrition, or premature birth may slightly increase the risk — but many cases have no clear cause.

How Pregnancy Factors Can Influence Risk

Infections: Some viruses and parasites in pregnancy can cross to the baby and cause lasting damage, even if the mother has only mild symptoms.

Congenital infections (passed from mother to baby during pregnancy) can lead to serious issues — including hearing loss, brain damage, and developmental delays. CMV and rubella are two of the most common culprits.

Malaysia has identified congenital CMV and toxoplasmosis as “common congenital illnesses with the potential to cause serious complications,” and efforts are ongoing to address this.

The good news? Malaysia has made big progress in prevention. The rubella vaccine is part of routine childhood immunisation, and nearly all pregnant women are screened for HIV and syphilis — for free. This program helped Malaysia become the first country in the Western Pacific to eliminate mother-to-child transmission of HIV and syphilis. Routine testing and early treatment make a huge difference — including preventing stillbirth and disability from untreated syphilis.

Nutrition: What a pregnant person eats affects the baby’s brain and body development — even before they know they’re pregnant.

Folic acid (400 mcg daily) before and during early pregnancy helps prevent neural tube defects like spina bifida. Other nutrients matter too — iron, iodine, vitamin D, and omega-3 fatty acids all support healthy development.

In Malaysia, many expectant mothers fall short on essential nutrients. One result? About 10% of babies are born underweight, which can affect growth and long-term brain health.

Maternal weight also plays a role — undernutrition can lead to smaller babies; too much weight or diabetes can lead to oversized babies and later health issues. Striking a healthy balance is key.

Substance use: Alcohol, tobacco, and drugs can cross the placenta and interfere with development. Even small amounts of alcohol can increase the risk of FASD (Fetal Alcohol Spectrum Disorders). There is no known safe level of alcohol in pregnancy.

Smoking increases risks of preterm birth, low birth weight, and certain birth defects. It may also increase the chance of learning and behavioural problems, like ADHD. Drug use, including prescription misuse (opioids, benzodiazepines), can cause withdrawal symptoms and developmental delays in newborns.

Support is available — prenatal care includes screening, counselling, and referrals to help parents quit substances safely.

Maternal health conditions: Chronic health issues during pregnancy can affect the baby’s development. For example, poorly controlled diabetes has been linked to higher risks of autism, ADHD, intellectual disability, and cerebral palsy. High blood pressure and preeclampsia may also be linked to neurodevelopmental issues.

Malaysian data shows that hypertension and high glucose in pregnancy are linked with growth restrictions and birth complications.

Other conditions, like autoimmune disorders, thyroid disease, and severe anaemia, can also impact development if not managed properly.

Premature birth: Babies born before 37 weeks face higher risks of disabilities. Preterm birth interrupts the final stages of brain and organ development, making complications more likely.

In Malaysia, about 12.3% of babies are born prematurely. It’s the second leading cause of death in children under five. Among babies born before 32 weeks, over 75% face at least one major complication.

Good prenatal care can help prevent preterm birth by identifying and managing risk factors early — such as infections, high blood pressure, and diabetes.

How Prenatal Care Helps (and What Parents Can Do)

The best news? Many of these risks can be reduced or prevented through regular prenatal care.

✔️ Early and Regular Checkups

Starting prenatal care in the first trimester allows for early detection and management of potential issues. In Malaysia, most pregnant women receive free antenatal services, which include blood tests (anaemia, diabetes, infections), urine tests (for preeclampsia), and ultrasound scans.

✔️ Vaccinations and Supplements

You’ll be prescribed prenatal vitamins with folic acid, iron, and calcium. Folic acid should ideally be taken before conception to prevent neural tube defects. If you’re not immune to rubella, your doctor may recommend the MMR vaccine before a future pregnancy.

✔️ Managing Health Conditions

Doctors help manage diabetes, hypertension, and other conditions with safe medications and monitoring. Well-managed diabetes, for example, carries much lower risks than untreated cases.

✔️ Substance Use and Nutrition Counselling

You’ll get guidance on healthy eating, avoiding risky substances, and achieving healthy weight gain. Support is available for those needing help to quit smoking, alcohol, or drugs.

✔️ Preventing Infections

You’ll be advised on food safety, hygiene, mosquito protection, and other practical steps. Screening for infections like UTIs and Group B strep is routine.

✔️ Specialised Care for High-Risk Pregnancies

High-risk pregnancies are monitored more closely and referred to specialist centres if needed. These clinics offer tailored care — from medication to prevent preterm labour to planning safe deliveries.

Malaysia’s Progress and Resources

Malaysia has made major strides in improving maternal-child health. Public clinics offer free antenatal services, routine screening, and essential supplements. National campaigns encourage pregnant women to attend antenatal classes (bengkel antenatal) and follow safe practices.

Still, gaps remain. Many pregnant women don’t get enough essential nutrients, and awareness about supplements like folic acid can be improved. The government is addressing this through food fortification and health education.

Malaysia’s diverse cultural landscape also means diet advice is tailored — local leafy greens, fortified rice, and tropical fruits are encouraged as nutrient-rich options.

Reassurance: Pregnancy Is One Factor Among Many

It’s natural to worry. But remember — disability doesn’t always come from something preventable. You can do everything right and still have a child with a genetic or developmental condition. That doesn’t mean you failed.

As the American College of Obstetricians and Gynecologists (ACOG) explains, many disabilities are due to genetic or chromosomal changes — like Down syndrome — that aren’t linked to lifestyle choices.

And many childhood disabilities (like autism, epilepsy, or learning disorders) aren’t fully understood and may develop well after birth.

The focus of prenatal care is to reduce preventable risks — not to promise a perfect baby. Health professionals are here to guide, not to judge.

What Expecting Parents Can Do

• Start prenatal care early and go regularly

• Eat a balanced diet and take recommended supplements (especially folic acid)

• Keep vaccinations up to date (MMR before pregnancy, Tdap and flu during)

• Avoid alcohol, tobacco, and recreational drugs

• Manage chronic health issues with professional support

• Practise infection prevention (food hygiene, handwashing, etc.)

• Report any warning signs (bleeding, headaches, unusual baby movement)

• Be kind to yourself — some things are just beyond anyone’s control

  
  

Final Word

Every pregnancy is unique. But with consistent care, accurate information, and support from Malaysia’s strong antenatal services, most parents can feel confident they’re giving their baby the best possible start.

Because in the end, prenatal care isn’t about perfection. It’s about preparation, prevention, and partnership. And with the right support, you’re never walking this journey alone.