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Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)

BD-STEPS builds upon the foundation of birth defects research from the National Birth Defects Prevention Study (NBDPS). This new study further examines findings from the NBDPS and follows up on leads to understand more about what causes birth defects and how to prevent them.



BD-StepsBD-STEPS is the next endeavor for the Centers for Birth Defects Research and Prevention (CBDRP) to understand the causes of birth defects.  The CBDRP will further examine promising findings from the National Birth Defects Prevention Study (NBDPS), one of the largest studies of birth defects causes in the United States. The NBDPS study provided important data on how nutrition, smoking, obesity and medicines affect pregnancies.  BD-STEPS will dig deeper into the results of that past research. 

BD-STEPS began collecting data on children born on or after January 1, 2014. Results from BD-STEPS will provide researchers with more knowledge about what factors might raise or lower the risk of having a baby with a birth defect. These are called risk factors. There are some things that a woman can change to reduce her chances of having a baby with a birth defect, while other things, she can’t change.  BD-STEPS aims to focus on risk factors that a woman may be able to change:

  • Diabetes, obesity, and physical activity
  • Treatments for chronic (long-term) medical conditions (such as asthma or high blood pressure)
  • Treatments for infertility
  • Other medication use during pregnancy

Baby with big smile with blocksThis study will provide important clues that will help CDC and our partners in our journey to ensure that every child is born with the best health possible.


BD-STEPS Study Centers

CDC coordinates the Centers for Birth Defects Research and Prevention (CBDRP) to collaborate on BD-STEPS. Participating sites are located in Arkansas, California, Georgia (CDC), Iowa, Massachusetts, New York, and North Carolina. 


Study Components

The study has two main parts:

  1. Interviewing women on the telephone: Interviewers talk with women who have had a pregnancy affected by a birth defect, as well as with mothers of babies who do not have a birth defect. The interviewers ask women about their pregnancy experience and general health.
  2. Collecting saliva (spit) from family members: After the interview, the study researchers send small sponges and containers to each family for collection of saliva (spit) from the mother, father, and baby. Saliva contains genetic material called DNA, which is used to examine the possible role of genes as risk factors for birth defects.


Birth Defects Included in this Study

Infant with a cleft lipThis study collects information on babies with 17 major birth defects. Researchers chose these 17 conditions, because they can be severe, they are more common, they incur high health care use or costs, they can be identified consistently across study sites, or because previous findings have warranted more in-depth research. The following major birth defects are included in BD-STEPS:


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Contact Us:
  • Centers for Disease Control and Prevention

    National Center on Birth Defects and Developmental Disabilities

    Division of Birth Defects and Developmental Disabilities

    1600 Clifton Road
    MS E-87
    Atlanta, GA 30333
  • 800-CDC-INFO
    TTY: (888) 232-6348
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