Intended for healthcare professionals

Letters Birth defects in Iraq

Is the Iraqi birth defects report believable?

BMJ 2013; 347 doi: (Published 22 October 2013) Cite this as: BMJ 2013;347:f6247
  1. Mozhgan Savabieasfahani, public health researcher1
  1. 1Ann Arbor, Michigan, USA
  1. mozhgan{at}

A report on the World Health Organization website now claims no evidence of adverse birth outcomes in Iraq.1 The undisclosed criteria for recruiting participants into this study “included areas that had and had not been exposed to bombardment or heavy fighting.”

In March 2013, a BBC documentary interviewed Ministry of Health researchers in Baghdad.2 Contrary to current claims, these researchers talked about the alarming rise in birth defects and cancers in Iraq. Dr Chaseb Ali, a senior Ministry of Health official, said: “All studies done by the Ministry of Health prove with damning evidence that there has been a rise in birth defects and cancers” in Iraq. In “Nineveh, Anbar, and Najaf” cancers and birth defects are increasing simultaneously, we are told.

How did “damning evidence” for an increase in birth defects and cancers turn into “no clear evidence” just six months later?

Even though data analysis is prone to variations in output, which can lead to changes in conclusions, it is difficult to know how a change of this magnitude might have occurred. On the basis of data in this report, misclassification and measurement errors cannot be ruled out. Nor can we rule out selection bias. The exposure status of the study populations was unknown throughout the report. How can a change in adverse reproductive outcomes be evaluated when exposure is unknown?

WHO’s history of suppressing information from Iraq is disquieting.3 Dr Keith Baverstock, the lead author of a WHO report that linked use of depleted uranium by the US and UK in Iraq to long term health risks, says his report was “deliberately suppressed.”4

Hans von Sponeck, former UN assistant secretary general, told Radio New Zealand on 22 September 2013 that WHO’s report on birth defects was “whitewashed.”5


Cite this as: BMJ 2013;347:f6247



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