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 toward 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 may be the first sign that infectious diseases, environmental, occupational, or nutritional factors, maternal conditions, or substance use can cause serious harm to pregnant people, 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 with these conditions.
Together, with state, territorial, and local health departments, academic centers, healthcare providers, and other partners, we are working toward 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 infant disorders by
- Strengthening state-based birth defects surveillance to improve capacity, data quality, and health outcomes of affected populations. NCBDDD now funds 10 state health departments for birth defects surveillance.
- Making key research contributions to understand risk factors for birth defects. NCBDDD and collaborators examined maternal smoking and congenital heart defects (CHDs) among participants in 10 states with data from the Centers for Birth Defects Research and Prevention. We found that multiple CHDs were modestly linked with any amount of cigarette smoking around the time of conception. NCBDDD and collaborators also examined the use of hydroxychloroquineexternal icon in mothers of babies with and without birth defects in the United States; we found that use of this medicine does not appear to increase the risk for birth defects. NCBDDD continues to study medicine use before and during pregnancy so people and their doctors can make informed decisions about health conditions and treatment.
- Continuing to monitor health inequities related to the risk of having a pregnancy with a neural tube defect (NTD). NCBDDD showed that voluntary fortification with folic acid has not yet had an impact on folate status among Hispanic women of reproductive ageexternal icon in the United States. In response, NCBDDD has developed a multiyear targeted strategy to identify and address the folic acid needs of this population.
- Prepared for, detected, and responded to emerging threats to pregnant people and their infants by
- Expanding the Surveillance for Emerging Threats to Mothers and BabiesNetwork (SET-NET) to include COVID-19. There are 31 jurisdictions currently conducting surveillance through SET-NET to examine COVID-19, hepatitis C, syphilis, and Zika virus.
- Informing public health and clinical recommendations for pregnant people. NCBDDD expertise and SET-NET data have been critical in CDC’s efforts to understand the effects of COVID-19 infection during pregnancy on birth and infant outcomes. By establishing that pregnant people with COVID-19 are at an increased risk of severe illness and adverse outcomes, SET-NET demonstrated the need for a strong recommendation for vaccination of pregnant people.
- Advanced scientific and programmatic activities to address the impact of substance use during pregnancy on maternal and infant health by
- Expanding surveillance to answer key questions about neonatal abstinence syndrome (NAS). NCBDDD collaborated with the Council on State and Territorial Epidemiologists to support six health departments for surveillance of NAS.
- Expanding the MATernaL and Infant NetworK (MAT-LINK)to understand outcomes from medicines used to treat opioid use disorder during pregnancy. NCBDDD added three new sites to the MAT-LINK system, bringing the number of sites to seven. In addition to the new locations, all sites will expand data collection of children from 2 years through 6 years of age. 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.
- Monitoring trends in alcohol use among pregnant people. NCBDDD found that during pregnancy, current drinking and binge drinking increased slightly from 2011 to 2018external icon. These data are important to help reduce alcohol-exposed pregnancies by identifying groups of women at increased risk of having an alcohol-exposed pregnancy and developing prevention programs aimed at reducing risk behaviors and improving pregnancy outcomes.
- Helping fill gaps in knowledge about opioid prescriptions for women of reproductive age. Opioid prescriptions among insured women aged 15-44 years have decreased over time but remain common. About 1 in 5 women with private insurance and about 1 in 4 women enrolled in Medicaid filled at least one opioid prescriptionexternal icon.
Looking to the Future
NCBDDD’s innovative mother-baby linked surveillance and long history of birth defects and infant disorders surveillance and research give our nation the best chance to protect pregnant people and infants, especially when facing emerging threats. Investments in modernizing and advancing our work enable CDC to continue strengthening a public health network that can rapidly assess the needs of pregnant people and their infants. We will continue addressing the impact of exposures during pregnancy, such as medicines, substance use, and infectious diseases, including COVID-19.
Additionally, we will continue identifying opportunities to prevent specific conditions, including CHDs, NTDs, gastroschisis, NAS, and fetal alcohol spectrum disorders. We also will work to reduce the impact of these conditions on health outcomes across the lifespan.
Notable Scientific Publications
- Bolin EH, Gokun Y, Romitti PA, et al. Maternal smoking and congenital heart defects, National Birth Defects Prevention Study, 1997-2011external icon. J Pediatr. Published online September 8, 2021.
- Denny CH, Acero CS, Terplan M, et al. Trends in alcohol use among pregnant women in the U.S., 2011–2018.external icon Am J Prev Med. 2020;59(5):768-769.
- Galang, RR, Newton SM, Woodworth KR, et al. Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection – Surveillance for Emerging Threats to Mothers and Babies Network, 22 state, local, and territorial health departments, March 29, 2020 -March 5, 2021.external icon Clin Infect Dis. 2021;73:S17–S23.
- Heinke D, Isenburg JL, Stallings EB, et al. Prevalence of structural birth defects among infants with Down syndrome, 2013-2017: A US population-based study. external iconBirth Defects Res. 2021;113(2):189-202.
- Howley MM, Werler MM, Fisher SC, et al. Maternal exposure to hydroxychloroquine and birth defects. external iconBirth Defects Res. 2021;113(17):1245-1256.
- Krause KH, Gruber JF, Ailes EC, et al. Assessment of neonatal abstinence syndrome surveillance — Pennsylvania, 2019external icon. MMWR Morb Mortal Wkly Rep 2021;70:40–45.
- Summers AD, Anderson KN, Ailes EC, et al. Venlafaxine prescription claims among insured women of reproductive age and pregnant women, 2011–2016.external icon Birth Defects Res. 2021;113(4):1052-1056.
- Wang A, Rose CE, Qi YP, et al. Impact of voluntary folic acid fortification of corn masa flour on RBC folate concentrations in the U.S. (NHANES 2011–2018).external icon Nutrients. 2021;13(4):1325.
- Woodworth KR, Olsen EO, Neelam V, et al. Birth and infant outcomes following laboratory-confirmed SARS-CoV-2 infection in pregnancy — SET-NET, 16 jurisdictions, March 29–October 14, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1635–1640.
- Zambrano LD, Ellington S, Strid P, et al. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22–October 3, 2020.external icon MMWR Morb Mortal Wkly Rep. 2020;69:1641–1647.