Saving Babies Through Surveillance, Research, and Prevention of Birth Defects and Infant Disorders
CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) is working towards a day when all babies are born with the best health possible.
Birth defects and infant disorders are common, costly, and critical conditions that can cause lifelong health challenges. They can be the first sign that infectious diseases, environmental hazards, or substances cause serious harm to pregnant women, infants, and children. Our unique surveillance, public health research, and world-renowned expertise provide a wealth of information used to
- Identify causes of birth defects and infant disorders;
- Find opportunities to prevent them; and
- Improve the health of those living with these conditions.
Together, with state, territorial, and local health departments, academic centers, healthcare providers, and other partners, we are working towards a day when all babies are born with the best health possible and every child thrives.
- Identified and applied targeted strategies to prevent birth defects and other infant disorders by
- Providing critical data showing that rates of infant deaths due to birth defects declined by 10% from 2003 to 2017 in the United States. However, birth defects are still a leading cause of infant death, and there are differences by race. NCBDDD also found that 1 in every 166 pregnancies ended in stillbirth during 2015–2017 in the United States. In addition, black mothers were more than twice as likely to experience a stillbirth compared to Hispanic and white mothers.
- Making key research contributions toward understanding risk factors for specific birth defects. NCBDDD clarified previous research findings on the relationship between use of antidepressants during early pregnancy and risk for specific birth defects. This study helps healthcare providers and their patients weigh the risks and benefits of using certain medicines during pregnancy.
- Continuing to monitor the impact of folic acid fortification in the United States to reduce the risk of having a pregnancy with a neural tube defect (NTD). While folic acid fortification of enriched cereal grains has been one of the most successful public health programs, NCBDDD, in collaboration with CDC’s National Center for Environmental Health, showed continued racial and ethnic differences in the risks for NTDs, with about 20% of the U.S. population still at risk for NTDs that can be prevented by folic acidexternal icon.
- Prepared, detected, and responded to emerging threats to pregnant women and their infants by
- Implementing and expanding Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). NCBDDD adapted the mother-baby linked surveillance approach from the Zika virus outbreak to detect and understand the impact of other exposures during pregnancy, such as COVID-19, hepatitis C, and syphilis. NCBDDD also contributed scientific expertise to CDC’s COVID-19 response to understand the effects of COVID-19 infection during pregnancy.
- Deepening our understanding of the effects of Zika virus infection during pregnancy. NCBDDD found that in 2 U.S. territories with widespread Zika virus transmission in 2016-2017, there was a four-fold increase in birth defects potentially related to Zika virus infection. NCBDDD and Colombia’s Instituto Nacional de Salud found that birth defects of the brain and eye were more common in Colombiaexternal icon during the Zika virus outbreak in 2015–2016 than before or after it and more common among women with Zika virus infection in the first trimester.
- Advanced scientific and programmatic activities to address the impact of substance use during pregnancy on maternal and infant health by
- Providing critical data on use of multiple substances (polysubstance use) during pregnancy showing that the use of substances, such as tobacco and marijuana, was common among pregnant women who reported alcohol use. To highlight this issue, NCBDDD also led a Public Health Grand Rounds on reducing polysubstance use during pregnancy.
- Strengthening surveillance to answer key questions. NCBDDD collaborated with the Council on State and Territorial Epidemiologists to support six health departments for surveillance of neonatal abstinence syndrome.
- Implementing and funding four clinical sites for MATernaL and Infant NetworK (MAT-LINK) to understand outcomes from treatment for opioid use disorder during pregnancy. This project received support from the U.S. Department of Health and Human Service’s Assistant Secretary for Planning and Evaluation’s Patient-Centered Outcomes Research Trust Fund.
- Developing tools and resources for healthcare providers. NCBDDD partnered with the MITRE Corporation to develop clinical decision support tools on alcohol screening and brief intervention that can be integrated into electronic health records. These tools can help healthcare providers deliver alcohol screening to women of reproductive age and offer evidence-based interventions to those at risk of excessive alcohol use.
Looking to the Future
NCBDDD’s innovative mother-baby linked surveillance and long history of birth defects and infant disorders surveillance and research gives our nation the best chance to protect pregnant women and infants, especially when we’re combatting emerging threats. Investments in modernizing and advancing our work allow CDC to continue strengthening a public health network that can rapidly assess the needs of pregnant women and their infants. We will continue addressing the impact of exposures during pregnancy, such as medicines, substance use, and infectious diseases. Additionally, we will continue identifying opportunities to prevent specific conditions, including congenital heart defects, neural tube defects, gastroschisis, neonatal abstinence syndrome, and fetal alcohol spectrum disorders, and to reduce their impact on health outcomes across the lifespan.
Notable Scientific Publications
- Almli LM, et al. Infant mortality attributable to birth defects—United States, 2003–2017. MMWR Morb Mortal Wkly Rep. 2020;69:25–29.
- Anderson KN, et al. Maternal use of specific antidepressant medications during early pregnancy and the risk of selected birth defectsexternal icon. JAMA Psychiatry. 2020;e202453.
- Ellington S, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:769–775.
- England LJ, et al. Alcohol use and co-use of other substances among pregnant females aged 12–44 years—United States, 2015–2018. MMWR Morb Mortal Wkly Rep. 2020;69(31):1009–1014.
- McKnight-Eily LR, et al. Screening for alcohol use and brief counseling of adults—13 states and the District of Columbia, 2017. MMWR Morb Mortal Wkly Rep. 2020;69(10);265–270.
- Ospina ML, et al. Zika virus disease and pregnancy outcomes in Colombiaexternal icon. N Engl J Med. 2020;383(6):537–545.
- Pruitt SM, et al. Racial and ethnic disparities in fetal deaths—United States, 2015–2017. MMWR Morb Mortal Wkly Rep. 2020;69:1277–1282.
- Reefhuis J, et al. Neural tube defects in pregnancies among women with diagnosed HIV infection—15 jurisdictions, 2013–2017. MMWR Morb Mortal Wkly Rep. 2020;69:1–5.
- Smoots AN, et al. Population-based surveillance for birth defects potentially related to Zika virus infection—22 states and territories, January 2016–June 2017. MMWR Morb Mortal Wkly Rep. 2020;69:67–71.
- Tinker SC, et al. Use of benzodiazepine medications during pregnancy and potential risk for birth defects, National Birth Defects Prevention Study, 1997–2011external icon. Birth Defects Res. 2019;111(10): 613–620.