Congenital Malformations Surveillance: Two American Systems

Abstract

As part of its epidemiologic studies of congenital malformations, the Centers for Disease Control (CDC) conducts two birth defects surveillance systems in the United States. The Metropolitan Atlanta Congenital Defects Programme (MACDP) is an intensive surveillance system using several methods to identify infants born with birth defects in the Atlanta area. The Birth Defects Monitoring Programme (BDMP) is a nationwide surveillance system that monitors 1 million births per year, about a third of all births in the U.S. It relies on diagnoses from newborn discharge summaries to ascertain affected infants. The systems were originally designed to detect potential 'epidemics' of birth defects that could occur following the widespread dissemination of new teratogens similar to thalidomide. In addition to monitoring, they have also proved to be useful resources for a variety of studies of the epidemiology of birth defects.

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

“…Birth weight and postnatal growth are recorded in all other OECD reproductive toxicity test guidelines. It is important in the evaluation of the data to consider (Edmonds et al, 1981;Lynberg & Edmonds, 1996) (also see chapter 4). Birth defect registries are available for some populations and are variations due to different litter sizes or different sex distribution in the litters.…”

Methodological considerations in the study of parental occupational exposures and congenital malformations in offspring.

“…The use of different ascertainment sources may result in varying prevalence estimates for a given malformation in that greater care may be taken to ensure complete and accurate information from some sources of information than from others. For example, while birth certificates are frequently used to ascertain malformations (table I, references 60 and 66) because of the relative ease and low cost, this method is well-known to underestimate the prevalence of malformations (4, 10,25) when compared to, say, a surveillance system such as the California Birth Defects Monitoring Program (26) or the Metropolitan Atlanta Congenital Defects Program (19), which actively monitor for malformations up to one year of life. However, some of the underreporting associated with the use of birth certificates is merely due to failure to record malformations on the birth certificate (69).…”

Monitoring for Congenital Malformations

“…Less published information is available on the maximum time allowed to transmit this information to the monitoring agency. It is usually between two and six months after birth (12,27,29,107). Once the agency receives the information, rapid analysis is also important.…”

“…Once the agency receives the information, rapid analysis is also important. In the CDC's Atlanta program the data are analyzed each month (27), in Sweden every two months (29), and in Italy by three months (107). An early age of cutoff is not without its problems.…”