Birth Defects Surveillance in the United States: Challenges and Implications of International Classification of Diseases, Tenth Revision, Clinical Modification Implementation

Abstract

Major birth defects are an important public health issue because they are the leading cause of infant mortality. The most common birth defects are congenital heart defects, neural tube defects, and Down syndrome. Birth defects surveillance guides policy development and provides data for prevalence estimates, epidemiologic research, planning, and prevention. Several factors influence birth defects surveillance in the United States of America (USA). These include case ascertainment methods, pregnancy outcomes, and nomenclature used for coding birth defects. In 2015, the nomenclature used by most birth defects surveillance programs in USA will change from ICD-9-CM to ICD-10-CM. This change will have implications on birth defects surveillance, prevalence estimates, and tracking birth defects trends.

Cost analysis of outpatient services for major external structural birth defects: An ingredient approach in selected hospitals in Kiambu County, Kenya

“…Low undertakings of cost studies, particularly in low-and middle-income economies have been attributed to the scarcity of data on the burden of these defects, 20,28,29 . Thus, the variations of annual direct economic costs could have been due to differences in the availability of the cost data, costing expertise, health services access, and utilization (economies of scale) 5,17,19,39 . Despite variations observed in the estimates of the economic costs, these findings point to the continuous disease burden associated with MESBDs in the county underpinning efficiency in resource utilization, and allocation for MESBDs in public and faith-based health facilities.…”

“…In Germany, the average annual health expenditure of persons with spina bifida was estimated at €4,532, with inpatient health services contributing €1,358 (30.0%), outpatient health services €644 (14.2%), rehabilitation health services €29 (0.6%), drug therapy €562 (12.4%), and other remedies €1,939 (42.8%)11 . In the United States among children aged between 1-17 years old, medical expenditures on spina bifida were estimated to cost 13 times as much as those on children without spina bifida37 .Notably, annual direct economic costs of different forms of major birth defects were estimated at $2.6 billion in 2004 in the United States of America,5,39 . Nonetheless, our study also endeavored to find and estimated the annual direct economic cost of MESBDs at $397,765.72.…”

Why are Birth Defects Surveillance Programs Important?

“…Monitoring reveals quantitative estimates of the magnitude of the disease. In this way, surveillance programs can identify clusters of congenital defects and serve as an early detection system for unexpected increases in their frequency resulting from the introduction of new and old teratogens in the population (12)(13)(14). For example, this was how misoprostol and the Zika virus were related to a cluster of birth defects and identified as teratogens initially (15,16).…”

Introductory Chapter: Epidemiology, Evaluation and Risk Assessment of Congenital Anomalies

“…Congenital anomalies (CA) are the leading cause of infant mortality in the USA (Figure 1) [1]. The five most common birth malformations recorded in the USA are club foot (1 in 593 births), Down syndrome (1 in 707 births), pulmonic stenosis/atresia (1 in 1052 births), cleft palate (1 in 1687 births), and limb defects (1 in1943 birth).…”