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APHA Scientific Session and Event Listing

Marcia Feldkamp, Health Sciences Center, University of Utah, 2C412 SOM, 50 N. Medical Drive, Salt Lake City, UT 84132, 801-257-0566 ext 203, jrinsky@asph.org

Objective: Major birth defects occur in 1 in 33 births, contribute to premature birth, and are responsible for 1 in 4 infant deaths. Birth defect surveillance programs provide the crucial public health infrastructure for assessment and prevention. In addition to monitoring occurrence, birth defect surveillance programs should help identify and track the main known causes of birth defects in the population, especially teratogens, as a guide to primary prevention activities.

Methods: The Utah Birth Defect Network conducts statewide ascertainment of birth defects among all pregnancy outcomes through multiple prenatal and postnatal reporting sources. Based on all information collected, a pediatric geneticist assigns each case an etiologic class based on the clinical findings, the etiologic information from medical records, and family history.

Results: From 1999 through 2003, 5,047 cases among 241,416 live born or stillborn infants were identifed. In 920 cases (18.2%) a known etiologic factor was present. In the remaining 4,127 or 81.8% of cases, etiology remained unknown. Known etiology included chromosomal conditions (745 or 81.0%), other genetic disorders (145 or 15.8%), teratogens (21 or 2.3%), and twinning (6 or 0.7%). Maternal diabetes accounted for most cases (57%) in the teratogen category.

Conclusion: Non-gestational maternal diabetes related embryopathy is preventable. Birth defects related to maternal diabetes are an important clinical and public health concern because they are preventable with appropriate glycemic control before conception and during early organogenesis. Etiologic classification of birth defects can enhance a birth defect surveillance program's ability to generate valuable data for public health prevention efforts.

Learning Objectives:

At the conclusion of this presentation, the audience will
• understand the importance of birth defects surveillance
• know the process for etiologic classification created and utilized by the Utah Birth Defect Network
• understand the need to reduce diabetes related birth defects.

Keywords: Birth Defects, Surveillance

Presenting author's disclosure statement:

Not Answered