The Iraq War may be over, but the casualties continue for Iraqi couples trying to have children without life-threatening birth defects.
An apparent rise in Iraqi birth defects has left parents, doctors and researchers scrambling for answers – and wondering whether there's a link between the war and babies born with deformities that often render them unable to survive until their first birthday.
"They [parents] feel desperate," Mozhgan Savabieasfahani, a reproductive toxicologist who used to work at the University of Michigan School of Public Health, told ABCNews.com. She traveled to Iraq's Fallujah General Hospital in 2010 to research the birth defects and co-authored studies in 2010 and 2012. "One major problem we had was that there weren't enough families who had normal children, and therefore we ended up with fewer normal family studies."
Savabieasfahani and her colleagues concluded that many Iraqi babies were born with congenital heart defects, spina bifida and other deformities because their parents had high levels of lead, mercury and uranium levels in their hair, nails and teeth. They suggested that the toxins came from airborne pollutants released during the Iraq War.
"Toxic metals such as mercury (Hg) and Pb [lead] are an integral part of war ammunition and are extensively used in the making of bullets and bombs," it says in the results section of the study.
However, the U.S. Department of Defense believes the evidence is insufficient to determine whether war pollutants caused a rise in birth defects, said department spokeswoman Cynthia Smith. For example, researchers did not account for whether mothers had adequate nutrition or access to medical care during pregnancy, and they did not always consider whether the parents were cousins, she said.
"The studies have instead relied on the occurrence of conflict during specified years, and then presumed exposure of individuals to specific munitions," Smith told ABCNews.com. "The studies have also presumed specific health effects from the claimed exposures without benefit of any scientific evidence proving the association of health effects with those exposures."
Savabieasfahani collected tissue samples from 56 families at Fallujah General Hospital to see whether parents of babies with birth defects had more lead and mercury in their bodies than parents of babies without birth defects. Savabieasfahani's co-author, Dr. Muhsin Al-Sabbak, collected similar data for 28 families at the Al Basrah Maternity Hospital, where he is a gynecologist and obstetrician.
They concluded that parents of children with birth defects had higher levels of lead, mercury and uranium than parents of normal children.
Savabieasfahani also wrote in her 2010 study that birth defects were present in 15 percent of all Fallujah births. (They make up 3 percent of births in the United States, according to the Centers for Disease Control and Prevention.)
However, the Federal Ministry of Health of Iraq and the World Health Organization have yet to release their joint study exploring the prevalence of birth defects in Iraq. Its results are expected to be published this spring. The study is a response to smaller, independent studies about birth defects, and an increased number of birth defect reports submitted to the ministry, according to the World Health Organization's website.
Savabieasfahani said it was sometimes difficult to persuade parents to participate in her study because birth defects are a source of shame in Fallujah. As such, she thinks birth defects and miscarriages may be underestimated.
Al-Sabbak, who is based in Basrah, Iraq, told ABCNews.com he is sure that more of his patients have either given birth to babies with multiple birth defects or suffered multiple miscarriages, and that many of them lived in areas where they would have been exposed to pollution from the war.
One of Al-Sabbak's patients had 19 miscarriages, Savabieasfahani said.
"They're actually asking whether they should stop conceiving," Al-Sabbak said. "They do ask me, 'What am I going to do?' I don't have the answer."