Background/Objectives: In this report, the National Birth Defects Prevention Network (NBDPN) examines and compares gastroschisis and omphalocele for a recent 5-year birth cohort using data from 30 population-based birth defect surveillance programs in the United States. Methods: As a special call for data for the 2019 NBDPN Annual Report, state programs reported expanded data on gastroschisis and omphalocele for birth years 2012–2016. We estimated the overall prevalence (per 10,000 live births) and 95% confidence intervals (CI) for each defect as well as by maternal race/ethnicity, maternal age, infant sex, and case ascertainment methodology utilized by the program (active vs. passive). We also compared distribution of cases by maternal and infant factors and presence/absence of other birth defects. Results: The overall prevalence estimates (per 10,000 live births) were 4.3 (95% CI:4.1–4.4) for gastroschisis and 2.1 (95% CI: 2.0–2.2) for omphalocele. Gastroschisis was more frequent among young mothers (<25 years) and omphalocele more common among older mothers (>40 years). Mothers of infants with gastroschisis were more likely to be underweight/normal weight prior to pregnancy and mothers of infants with omphalocele more likely to be overweight/obese. Omphalocele was twice as likely as gastroschisis to co-occur with other birth defects. Conclusions: This report highlights important differences between gastroschisis and omphalocele. These differences indicate the importance of distinguishing between these defects in epidemiologic assessments. The report also provides additional data on co-occurrence of gastroschisis and omphalocele with other birth defects. This information can provide a basis for future research to better understand these defects.

Posttraumatic stress disorder (PTSD), anxiety, and depression are the most common mental health disorders in the refugee population. High rates of violence, trauma, and PTSD among refugee women remain unaddressed. The process of implementing a mental health screening tool among multi-ethnic, newly-arrived refugee women receiving routine obstetric and gynecologic care in a dedicated refugee women’s health clinic is described. The Refugee Health Screener-15 (RHS-15) is a culturally-responsive, efficient, validated screening instrument that detects symptoms of emotional distress across diverse refugee populations and languages. An interdisciplinary community partnership was established with a local behavioral health services agency to facilitate the referral of women scoring positive on the RHS-15. Staff and provider training sessions, as well as the incorporation of bi-cultural, multi-lingual Cultural Health Navigators, greatly facilitated linguistically-appropriate care coordination for refugee women in a culturally sensitive manner. Twenty-six (23.2%) of the 112 women who completed the RHS-15 scored positive; of which 14 (53.8%) were Iraqi, one (3.8%) was Burmese, and three (11.5%) were Somali. Among these 26 women, eight (30.8%) are actively receiving mental health services, and five (19.2%) have appointments scheduled. However 13 (50%) are not enrolled in mental health care due to either declining services (46.2%), or a lack of insurance (53.8%). Screening for mental disorders among refugee women will promote greater awareness and identify those individuals who would benefit from further mental health evaluation and treatment. Sustainable interdisciplinary models of care are necessary to promote health education, dispel myths and reduce the stigma of mental health.

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Background Both short and long interpregnancy intervals (IPIs) have been associated with adverse birth outcomes. We undertook a multistate study to describe the prevalence of selected birth defects by IPI. Methods We obtained data from nine population‐based state birth defects registries for singleton live births in 2000–2009 among mothers with a previous live birth identified through birth certificates. IPI was calculated as the difference between prior birthdate and start of the current pregnancy (conception date). We estimated prevalence of selected defects per 10,000 live births and prevalence ratios (PRs) with 95% confidence intervals (CIs) overall and stratified by maternal age at previous birth and race/ethnicity. Primary analyses focused on short IPI < 6 months and long IPI ≥ 60 months compared to 18–23 months (referent). Sensitivity analyses limited to active‐surveillance states and those with<10% missing IPI. Results Among 5,147,962 eligible births, 6.3% had short IPI while 19.8% had long IPI. Compared to referent, prevalence with short IPI was elevated for gastroschisis (3.7, CI: 3.0–4.5 vs. 2.0, CI: 1.6–2.4) and with both short and long IPI for tetralogy of Fallot (short: 3.4, 2.8–4.2 long: 3.8, 3.4–4.3 vs. 2.7, 2.3–3.2) and cleft lip ± palate (short: 9.9, 8.8–11.2 long: 9.2, 8.5–9.8 vs. 8.4, 7.6–9.2). Stratified analyses identified additional associations, including elevated prevalence of anencephaly with short IPI in younger mothers and limb defects with long IPI in those ages 25–34 at prior birth. Sensitivity analyses showed similar results. Conclusion In this population‐based study, we observed increased prevalence of several birth defects with short and long IPI.

Care coordination (CC) has shown positive outcomes among children with special health care needs (CSHCN); however, the association between CC and well-child care (WCC) visits is unknown. We hypothesize that CSHCN who receive CC are more likely to attend the recommended WCC visits. A retrospective cohort analysis was conducted of patients aged 15 months attending the Arizona Children’s Center clinic. Logistic regression models explored the association between children receiving CC and attending the recommended minimum WCC visits before 15 months of age. CC was associated with higher odds of proper WCC attendance (any CC service, adjusted odds ratio = 2.14, 95% confidence interval = 1.75-2.62; high level of CC, adjusted odds ratio = 2.61, 95% confidence interval = 1.73-3.94). Pediatric CC is associated with greater up-to-date status of the WCC schedule among CSHCN 15 months of age, and higher odds among children who receive higher levels of CC. Further research is needed to validate findings.

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BackgroundThe Arizona Birth Defects Monitoring Program (ABDMP) creates case‐finding lists of potential birth defects. As part of this, ABDMP includes all fetal death records, in addition to records for mothers and infants with an associated birth defect code. This project aims to understand the value of including all fetal deaths in case‐finding, and to assess the impact on the rate of birth defects if all fetal death cases are not reviewed.MethodsWe assessed 2016–2017 fetal death records based on case‐finding source and ICD‐10 CM codes. We categorized cases by whether they had a hospital discharge ICD‐10 CM code indicating a maternal diagnosis for a fetal anomaly (i.e., “O35” code), and compared them to cases reported only by a stillbirth code, meaning that a baby was born deceased, with no reference to birth defects. Positive and negative predictive values were calculated (PPV, NPV, respectively).ResultsFor 2016–2017, fetal deaths make up 6% (n = 89) of all confirmed birth defects (n = 1,416), and fetal deaths with no O35 code make up 4% (n = 54) of all confirmed birth defects cases in Arizona. Had cases without an O35 code not been included, 4% (n = 54) of confirmed birth defect cases in Arizona for 2016–2017 would have been missed. The PPV was 68.6%.ConclusionThe work involved in reviewing the additional 1,000 records per year is warranted by the value noted. It is evident that by including all fetal deaths we capture a more accurate picture of the occurrence of birth defects in Arizona.