Program ABDMP ABDMP 3 Components Surveillance Prevention Referral to Services Surveillance Surveillance Goals Timely Accurate Complete Data Bureau of Public Health Statistics CDC ID: 706155
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Slide1
Arizona Birth Defects
Monitoring
Program
(ABDMP)Slide2
ABDMP
3 Components:
Surveillance
Prevention
Referral to ServicesSlide3
SurveillanceSlide4
Surveillance
Goals: Timely, Accurate, Complete Data
Bureau
of Public Health
Statistics
CDC
and National Birth Defects Prevention
Network
s
tandards and recommendations
Data calls for CDC, NBDPN,
Birth Defects Research
publication; multi state research projects; cluster studiesSlide5
ABDMP Surveillance
33 categories of defects
Population based registry
Active surveillance
Sources:
Hospital Discharge data
Hospital Discharge Indices
Birth and Fetal Death CertificatesSlide6
Significance in Arizona
Arizona:
1,500
children are born with serious birth defects every
year
the
reportable birth defect rate for Arizona is 7.9 cases per 1,000 live and still births
.
In
2009, children (0-17) with birth defects accounted for about 13.3% of all pediatric hospitalizations
.
Birth defects are a leading cause of death for infants
(>
28 days; < 365 days
)
20% of all infant deaths
Each year, more infant deaths are attributed to birth defects than prematurity and SIDS/SUIDS combinedSlide7
Arizona TotalsSlide8
Arizona
The most common type of anomalies are congenital heart
defects (CHDs).
The
most common
specific
anomalies observed for 2010
are Down
syndrome,
oral clefts, pulmonary
valve atresia/stenosis, and
gastroschisis
.
AZ has higher than average rates of oral cleft defects, and slightly higher rates of
spina
bifidaSlide9
Home Births and Birth Defects
2000-2011: 1-5 homebirths of children with birth defects per year
Anomalies noted vary greatly; include:
Down Syndrome
Cleft lip with and without cleft palate/Cleft palate
Various CHDs
Tetralogy
of
Fallot
Coarctation
of Aorta
Transposition of the Great Arteries
Gastroschisis
Congential
Diapragmatic
Hernia
“Lethal” anomalies
Anencephaly; Trisomy 13, 18
Families with “lethal” diagnoses
may
choose to delivery at home
or birthing centers to
limit medical intervention/interference and to improve quality of time with childSlide10
*Important Notes*Slide11Slide12
Associations
Down Syndrome
Higher rates of heart defects, hearing loss,
Oral Clefts
Midline defect
Syndromes
Feeding issues
CHDs
25% are not
diagnosed prenatally
May not present for several days or even months
Pulse
oximetry
screeningSlide13
PreventionSlide14
Prevention
Primary
– Prevent Birth Defects
Secondary
– Prevent Morbidity & Quality of Life Issues
Tertiary
– Preventing Birth Defect Related Deaths
Slide15
Secondary and Tertiary Prevention
Newborn Screening
Hearing Screening
Pulse
Oximetry
Screening
Secondary Issues/ Associations
standard screenings
geneticsSlide16
Primary Prevention:
The
causes of 65-75% of birth defects are unknown.
Known
causes
include
:
Genetics
15-25%
Environmental
10%
Maternal
Conditions
Infections
ExposuresSlide17
Areas for Intervention
Preconception/Prenatal/
Interconception
HealthSlide18
Folic acidCDC recommends 400 mg daily for women of childbearing age
Taking
folic acid before pregnancy can reduce the risk of NTDs by up to 70%
Inadequate folic acid also linked to increased risk of oral clefts, Down syndrome, autism…
Interpregnancy
Intervals
18-24 months between end of pregnancy and conception of next
Regardless of outcome: miscarriage, preterm, stillbirth; live birth
40
% increase in low birth weight babies
Potential increased
risk of miscarriage, preterm birth, low birth weight, birth defects, maternal death
Alcohol and other drug exposure
Alcohol
exposure during pregnancy is the leading preventable cause of birth defects, cognitive disabilities, and neurobehavioral disorders.
Alcohol affects whatever organ or system that is currently growing, including:
Brain, heart, bones, kidneys, eyes, ears, faceSlide19
Referral to ServicesSlide20
Referral
Medical Treatment
Babies with birth defects born at home were seen at hospitals same day-months after delivery
Support Programs
Social workers
Community groups with hospital visitationSlide21
Resources
http://
www.azdhs.gov/phs/phstats/bdr/resources.htm
ADHS website: A to Z Index: B: Birth Defects Monitoring Program
Sharing Down Syndrome
Down Syndrome Network
Spina
Bifida Association of Arizona
Feeding Matters
Mended Little HeartsSlide22
Dianna Contreras
Arizona Birth Defects Monitoring Program Manager
dianna.contreras@azdhs.gov
602 542 7335
abdmp@azdhs.gov