PRAMSgram, summer 2012, v.16 no.2

              MATERNAL & CHILD HEAL TH SERVICE • OKLAHOMA STATE DEPARTMENT OF HEAL TH
OKLAHOMA PREGNANCY RISK ASSESSMENT MONITORING SYSTEM VOL 16 NO 2 SUMMER 2012
Birth Defects in Oklahoma
Introduction:
Congenital anomalies or birth defects are structural
defects that are present at birth.1 Birth defects range
from relatively minor to serious conditions requiring
immediate medical intervention or lifelong care.
Congenital anomalies affect 3% of babies born in
the United States.2 From 2004-2008, the cumulative
prevalence of all birth defects in Oklahoma was 42.11
per 1,000 live births with a range of 45.53 per 1,000 live
births in 2004 to 39.45 per 1,000 live births in 2008.
Birth defects are quite costly and result in numerous
hospitalizations and increased infant mortality. In 2004,
there were 139,000 hospitalizations associated with
congenital anomalies in the United States with hospital
costs totaling $2.6 billion.3 In Oklahoma, congenital
anomalies accounted for 1,511 hospitalizations in
2008 (the latest data available) resulting in an average
length of stay of 6 days and $56,736 in average hospital
charges per stay.4 Nationally, birth defects accounted
for 20.4% (5,819/28,527) of deaths among infants less
than one year of age in 2006.5 In Oklahoma from 2002-
2006, birth defects were the second leading cause of
death in infants (less than one year of age) and were
responsible for 21.9% (450/2,055) of infant deaths.6
Risk factors for congenital anomalies include genetic,
environmental, and maternal factors. Congenital
anomalies have been linked to maternal exposure to
tobacco, alcohol, illicit drugs, medications, and chemicals,
as well as maternal health conditions such as illness,
infections, and chronic health conditions like diabetes
and obesity (body mass index (BMI) ≥ 30).6-7 Since
approximately 70% of birth defects have an unknown
etiology, further exploration into the etiology of birth
defects is necessary.8-9
The Oklahoma Birth Defects Registry § 63 Section
1-550.2 statute gives the Oklahoma State Department
of Health (OSDH) the responsibility for operating
In Oklahoma:
• Oklahoma Birth Defects Registry data indicate that
42.1 infants per 1,000 live births were born with a
birth defect from 2004-2008.
• Singleton infants of 2004-2008 PRAMS
respondents (n=759) were linked to records in the
Oklahoma Birth Defects Registry.
• Eighty-eight percent of mothers of infants with
birth defects were white.
• Almost 70% of mothers had prenatal care
or delivery services paid for by Medicaid/
SoonerCare.
• The most common birth defect in the linked
dataset was an atrial septal defect impacting 23%
of the 759 infants in the sample.
the birth defects registry and assuring confidentiality
of the data collected. The Oklahoma Birth Defects
Registry (OBDR) utilizes an active case ascertainment
from delivery, pediatric, and tertiary care hospitals.
Medical information related to the infant’s birth
defect is collected on over 470 conditions during the
newborn period and up to three years after birth. The
OBDR functions to protect and promote the health
of Oklahomans through statewide surveillance and
investigation, thereby identifying opportunities to
prevent birth defects, optimize early detection of birth
defects, and reduce infant mortality. The OBDR started
in 1992 with active surveillance in eight Oklahoma
County hospitals. In 1994, the OBDR was instituted
statewide and active abstraction continues in all birthing
hospitals. The OBDR contributes data to the Centers
for Disease Control and Prevention (CDC), so that CDC
can calculate national birth defects prevalence rates.
Since 1997, the OBDR has promoted the use of folic
acid to reduce the prevalence of neural tube defects and
provides folic acid at no cost to women of reproductive
age through county health departments.