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Saving Babies Through Birth Defects Prevention and Research

Listening to a baby's heart with a stethoscope.Saving Babies

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 are common, costly, and critical. Our unique state-based birth defects tracking and public health research provide a wealth of information that we use to identify causes of birth defects, find opportunities to prevent them, and improve the health of those living with birth defects. Together with states, universities, 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.

Budget and Funding


  • Contributed to what is known about Zika virus infection during pregnancy. Used information collected from the U.S. Zika Pregnancy and Infant Registry for public health action to protect mothers and babies from Zika virus infection. The information from this innovative surveillance answered questions related to Zika virus infection during pregnancy, resulted in updated recommendations for clinical care, guided planning for medical and social services for affected families, and improved prevention of Zika virus infection during pregnancy.
  • Confirmed the link between maternal fever during early pregnancy and an increased chance for having a baby with a neural tube defect (NTD) using two independent information sources: CDC funded National Birth Defects Prevention Study, which looked for a link between fever and 29 other birth defects and the Slone Epidemiology Center Birth Defects Study, which found that daily folic acid intake reduced the chance for an NTD.
  • Supported research efforts to link a group of infants identified with neonatal abstinence syndrome (NAS) in Tennessee Medicaid claims information to Tennessee Department of Education information to understand the long-term neurodevelopmental outcomes potentially related to NAS. This pilot project is the first to look at connections between NAS and special education needs in U.S. children.
  • Provided new information on alcohol screening and brief intervention (SBI) that showed most adults who drank at risky levels and were asked about their alcohol use during checkups were not advised to drink less. Supported CDC’s Collaborative for Alcohol-Free Pregnancy to promote alcohol SBI, which included implementing a model in a large health system in Texas that engaged health professionals from multiple disciplines. Worked with partners to develop resources promoting the prevention and recognition of fetal alcohol spectrum disorders, such as the launch of an online PediaLink course from the American Academy of Pediatrics.
  • Analyzed National Health and Nutrition Examination Survey information to predict the chances among various groups of U.S. women of having a pregnancy affected by a neural tube defect (NTD). About 1,300 NTDs are prevented each year through food fortification with folic acid. However, additional birth defects could be prevented if folic acid consumption is increased among women with low consumption. Worked with partners in Tanzania to increase market supply and demand for maize flour fortified with folic acid and other nutrients produced by small- and medium-scale mills. Worked with partners in Haryana State, India to assess the health impact of fortifying wheat flour with folic acid, vitamin B12, and iron.
Birth Defects are Critical: Birth defects cause a in every 5 deaths during the first year of life

Looking to the Future

NCBDDD will continue its work to protect women and babies through our birth defects tracking and public health research. These activities provide knowledge about the factors that might increase or decrease the risk of having a baby with a birth defect. Our work in Zika virus is a reminder of the medical vulnerability of mothers and babies to emerging infections and other threats, and the impact of infections diseases and other exposures during pregnancy. We will continue to leverage the innovative tracking and monitoring system developed to combat Zika virus and respond rapidly to other emerging threats that affect mothers and babies.

Notable Scientific Publications

Honein MA, et al. Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy. JAMA. 2017;317(1):59-68.

Howley M, et al. Thyroid Medication Use and Birth Defects in the National Birth Defects Prevention Study. Birth Defects Res. 2017;109(18):1471-81.

Lind J, et al. Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review. Pediatrics. 2017;139(6):e20164131.

Lynch M, et al. Making Decisions About Medication Use During Pregnancy: Implications for Communication Strategies. Matern Child Health J. 2017 Sep 12.

McKnight-Eily LR, et al. Screening for Excessive Alcohol Use and Brief Counseling of Adults — 17 States and the District of Columbia, 2014. MMWR Morb Mortal Wkly Rep. 2017;66(12):313-9.

Oduyebo T, et al. Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States (Including U.S. Territories), July 2017. MMWR Morb Mortal Wkly Rep. 2017;66(29):781-93.

Parra-Saavedra M, et al. Serial Head and Brain Imaging of 17 Fetuses with Confirmed Zika Virus. Obstet Gynecol. 2017;130(1):207-12.

Reynolds MR, et al. Vital Signs: Update on Zika Virus-Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure – U.S. Zika Pregnancy Registry, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(13):366-73.

Rosenthal J, et al. Folate Deficiency Is Prevalent in Women of Childbearing Age in Belize and Is Negatively Affected by Coexisting Vitamin B-12 Deficiency: Belize National Micronutrient Survey 2011.  J Nutr. 2017 Jun;147(6):1183-93

Shapiro-Mendoza CK, et al. Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016–April 25, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(23):615-21.

Spotlight On: American Academy of Pediatrics | The National Birth Defects Prevention Network

Birth defects are common, costly, and critical. CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) saves babies by preventing birth defects. NCBDDD identifies causes of birth defects, finds opportunities to prevent them, and improves the health of those living with birth defects.

Fetal Alcohol Spectrum Disorders

The American Academy of Pediatrics (AAP) Fetal Alcohol Spectrum Disorders (FASD) Regional Education and Awareness Liaisons (REAL) Champions Network was established in 2016 under a cooperative agreement between AAP and NCBDDD. The FASD REAL Champions Network supports the goals of CDC’s FASD program through innovative education and awareness building activities. During its first year, the FASD REAL Champions Network reached over 1,200 pediatric clinicians with presentations on FASD screening, assessment and diagnosis; neurobehavioral disorder associated with prenatal alcohol exposure; and lifelong care for individuals with FASDs.

Recent studies indicate that from 2-5% of school aged children may have a FASD. Pediatric clinicians need an enhanced level of awareness, education, and guidance on the identification, treatment, and management of infants and children who were prenatally exposed to alcohol, some of whom may have one of the FASDs. The FASD REAL Champions Network aims to play a vital role in reducing alcohol exposed pregnancies and identifying and coordinating care for children with a FASD.

National Birth Defects Prevention

The National Birth Defects Prevention Network (NBDPN) was formed in 1997 as a non-profit organization of state-based programs, partner agencies, and other volunteers to advance science and its application to prevention through birth defects surveillance. The NBDPN assesses the impact of birth defects upon communities; identifies factors that can be used to develop primary prevention strategies; and assists families and their providers in secondary disabilities prevention.

Recently, NBDPN collaborated with NCBDDD to support state programs to conduct rapid tracking of Zika-related birth defects. A NBDPN Zika Response Group was formed to discuss case definitions for the defects to monitor, potential data variables to collect, rapid ascertainment methodologies, and other resources, such as assisting with a data collection tool development.  The NBDPN published a state data brief on microcephaly and also worked with CDC to establish the baseline occurrence of microcephaly in the United States prior to Zika. These data provided crucial information to determine the elevated risk of Zika virus on developing babies. The NBDPN continues to assess and support state programs as they continue to monitor Zika-related birth defects and other major birth defects.