MONITORING, SERVICES AND PREVENTION OF BIRTH DEFECTS IN MINNESOTA:

Size: px
Start display at page:

Download "MONITORING, SERVICES AND PREVENTION OF BIRTH DEFECTS IN MINNESOTA:"

Transcription

1 MONITORING, SERVICES AND PREVENTION OF BIRTH DEFECTS IN MINNESOTA: THE MINNESOTA BIRTH DEFECTS MONITORING AND ANALYSIS PROGRAM Barbara Frohnert, MPH Epidemiologist Kristin Peterson Oehlke, MS, CGC Genetic Counselor and Supervisor Jan Sieger RN MPH FNP Birth Defects Specialist

2 GOALS Surveillance: Describe the history of birth defects surveillance in Minnesota, Describe the specific birth defects included in the Birth Defects Information System, Review progress to statewide surveillance Present current birth defects prevalence data, Describe the collaboration with the Newborn Screening Program to implement screening for Critical Congenital Heart Defects Research Opportunities for future research Services Highlight the partnership with local public health agencies to coordinate care for this population, Prevention Provide a preview of the primary and secondary prevention efforts that aim to minimize the incidence and impact of birth defects in Minnesota

3 PROGRAM HISTORY

4 PROGRAM BACKGROUND 3-5% of live births have major structural birth defects. 2,100-3,500 Minnesota children are born each year with a major birth defect. Birth defects are the leading cause of death for children <1 yr old Causes of Birth Defects: 20% genetics 10% environmental factors 70% unknown

5 MINNESOTA BIRTH DEFECTS SURVEILLANCE 1996: work toward birth defects surveillance began 1997 report to the state legislature 2002: CDC planning grant received to fund surveillance work on birth defects. 2004: Minnesota State Legislature created birth defects program 2005: Surveillance began in Hennepin & Ramsey using CDC implementation surveillance grants 2010: Minnesota State Legislature provided funding for birth defects program

6 MDH BIRTH DEFECTS PROGRAM GOALS Monitor trends of birth defects Accurately target intervention, prevention, and services for communities, patients and their families Inform health professionals of the risks for birth defects Participate in scientific investigation of potential causes and prevention of birth defects

7 STAFFING Supervisor Genetic Counselor Surveillance 2 epidemiologists 4 Abstractors Information Tech Specialist (MEDSS) 3 Contracted MD Consultants Services 2 Nurse Practitioners Operations Coordinator Prevention Prevention and Education Specialist Women s Health Consultant

8 SURVEILLANCE

9 PROCESS Surveillance covers 45 selected major structural defects 46 th condition will be added in 2013 Conditions must be diagnosed by 1 year of age Most of these conditions are diagnosed at birth Case criteria follows the guidelines established by the National Birth Defects Prevention Network (NBDPN), the national network of state and population-based birth defects programs Families can choose to have their identifying information removed (Opt-out) Families who do not opt out are referred to their local public health agency for services and referrals.

10 IDENTIFYING BABIES WITH BIRTH DEFECTS Most cases are identified from medical records at hospitals and NICUs Additional cases are identified on check boxes on birth certificates New birth certificates have fewer congenital anomalies listed Limited to those that are easily identifiable at birth Collecting accurate data should be easier and more complete Other sources include: Medicaid claims, Newborn Hearing Follow-up Program, outpatient clinics

11 MINNESOTA MONITORS 46 CONDITIONS: CARDIAC Aortic Valve Stenosis Atrial Septal Defect (ASD) (PFO) Coarctation of the Aorta Common Truncus Ebstein's Anomaly Endocardial Cushion Defect (AV Canal) Hypoplastic Left Heart Syndrome Patent Ductus Arteriosus (PDA) Pulmonary Valve Atresia and Stenosis Single Ventricle Tetralogy of Fallot Transposition of the Great Arteries Tricuspid Valve Atresia and Stenosis Ventricular Septal Defect (VSD) Total Anomalous Pulmonary Venous Return (TAPVR) NEW for 2013

12 MINNESOTA MONITORS 46 CONDITIONS: CENTRAL NERVOUS SYSTEM, CHROMOSOME, EAR, EYE Central Nervous System Anencephalus Encephalocele Hydrocephalus Microcephalus Spina Bifida Chromosome Down Syndrome Trisomy 13 Trisomy 18 Eye Aniridia Anophthalmia and Microphthalmia Congenital Cataract Ear Anotia / Microtia

13 MINNESOTA MONITORS 46 CONDITIONS: GASTROINTESTINAL, GENITOURINARY Gastrointestinal Biliary Atresia Esophaegeal Atresia Hirschsprung's Disease Pyloric Stenosis Rectal and Large Intestinal Atresia / Stenosis Genitourinary Bladder Exstrophy Hypospadias and Epispadias Obstructive Genitourinary Defect Renal Agenesis / Hypoplasia

14 MINNESOTA MONITORS 46 CONDITIONS: MUSCULAR SKELETAL, ORAL, OTHER Muscular Skeletal Congenital Hip Dislocation Diaphragmatic Hernia Gastroschisis Omphalocele Reduction Deformity: Lower Limbs Reduction Deformity: Upper Limbs Oral Choanal Atresia Cleft Lip and Palate Cleft Palate without Cleft Lip Other Health Conditions Fetal Alcohol Syndrome (FAS)

15 Defect MOST COMMON BIRTH DEFECTS COUNTS AND PREVALENCE RATES FOR HENNEPIN AND RAMSEY COUNTIES, RANKED BY FREQUENCY ( DATA, TOTAL LIVE BIRTHS = 96,859) N Rate per 10,000 live births Total Defects Body System Category Atrial septal defect Cardiovascular Ventricular septal defect Cardiovascular Hypospadias and Epispadias Genitourinary Obstructive genitourinary defect Genitourinary Patent ductus arteriosus Cardiovascular Pyloric stenosis Gastrointestinal Down Syndrome Chromosomal Cleft lip with and without cleft palate Orofacial Pulmonary valve atresia and stenosis Cardiovascular Cleft palate without cleft lip Orofacial

16 OTHER USES OF DATA Planning for implementation of newborn Critical Congenital Heart Disease screening using pulse oximitry Environmental Public Health Tracking program: Birth Defects Data & Measures report

17 ESTIMATED NUMBER OF CASES OF CCHD IN MINNESOTA Critical Congenital Heart Defects Estimated Expected Annual Case Count* Estimated from all cases identified in BDIS, regardless of maternal residence Estimated using rates from Hennepin/Ramsey Counties only, Hypoplastic Left Heart Syndrome Pulmonary Atresia Tetralogy of Fallot Total Anomalous Pulmonary Venous Return N/A N/A Transposition of the Great Arteries Tricuspid Valve Atresia & Stenosis 5 5 Truncus Arteriosus 5 4 Total CCHD, excluding TAPVR * One child may have more than one of these defects and may be counted twice. Total number of children with CCHD, excluding TAPVR Data from MN BDIS

18 RESEARCH

19 RESEARCH GOALS AND OBJECTIVES Drafted in spring 2012 Overarching Goal: By the end of 2014, establish a foundation for including Minnesota birth defects surveillance data in ongoing analysis and research on birth defects.

20 RESEARCH GOAL #1 Establish a multidisciplinary birth defects research network in Minnesota Objective 1a: Establish a birth defects research network within MDH by the end of 2012 Newborn Screening program Environmental Public Health Tracking Objective 1b: Establish a statewide multidisciplinary birth defects research network in Minnesota by the end of 2014 If you are interested in getting involved in the planning, please let us know today.

21 RESEARCH GOAL #2 Establish an infrastructure and framework to facilitate the use of Minnesota birth defects data in research. Objective 2a: Establish a process for researchers to apply to use birth defects data by June 30, 2013 Objective 2b: Establish a process for reviewing and approving or declining research projects that seek to use birth defects data by June 30, 2013 Objective 2c: Establish a process for estimating costs associated with research and a mechanism to recoup these costs by the end of 2013

22 MINNESOTA MONITORS 46 CONDITIONS: GASTROINTESTINAL, GENITOURINARY Gastrointestinal Biliary Atresia Esophaegeal Atresia Hirschsprung's Disease Pyloric Stenosis Rectal and Large Intestinal Atresia / Stenosis Genitourinary Bladder Exstrophy Hypospadias and Epispadias Obstructive Genitourinary Defect Renal Agenesis / Hypoplasia

23 MINNESOTA MONITORS 46 CONDITIONS: MUSCULAR SKELETAL, ORAL, OTHER Muscular Skeletal Congenital Hip Dislocation Diaphragmatic Hernia Gastroschisis Omphalocele Reduction Deformity: Lower Limbs Reduction Deformity: Upper Limbs Oral Choanal Atresia Cleft Lip and Palate Cleft Palate without Cleft Lip Other Health Conditions Fetal Alcohol Syndrome (FAS)

24 Defect MOST COMMON BIRTH DEFECTS COUNTS AND PREVALENCE RATES FOR HENNEPIN AND RAMSEY COUNTIES, RANKED BY FREQUENCY ( DATA, TOTAL LIVE BIRTHS = 96,859) N Rate per 10,000 live births Total Defects Body System Category Atrial septal defect Cardiovascular Ventricular septal defect Cardiovascular Hypospadias and Epispadias Genitourinary Obstructive genitourinary defect Genitourinary Patent ductus arteriosus Cardiovascular Pyloric stenosis Gastrointestinal Down Syndrome Chromosomal Cleft lip with and without cleft palate Orofacial Pulmonary valve atresia and stenosis Cardiovascular Cleft palate without cleft lip Orofacial

25 OTHER USES OF DATA Planning for implementation of newborn Critical Congenital Heart Disease screening using pulse oximitry Environmental Public Health Tracking program: Birth Defects Data & Measures report

26 ESTIMATED NUMBER OF CASES OF CCHD IN MINNESOTA Critical Congenital Heart Defects Estimated Expected Annual Case Count* Estimated from all cases identified in BDIS, regardless of maternal residence Estimated using rates from Hennepin/Ramsey Counties only, Hypoplastic Left Heart Syndrome Pulmonary Atresia Tetralogy of Fallot Total Anomalous Pulmonary Venous Return N/A N/A Transposition of the Great Arteries Tricuspid Valve Atresia & Stenosis 5 5 Truncus Arteriosus 5 4 Total CCHD, excluding TAPVR * One child may have more than one of these defects and may be counted twice. Total number of children with CCHD, excluding TAPVR Data from MN BDIS

27 RESEARCH

28 RESEARCH GOALS AND OBJECTIVES Drafted in spring 2012 Overarching Goal: By the end of 2014, establish a foundation for including Minnesota birth defects surveillance data in ongoing analysis and research on birth defects.

29 RESEARCH GOAL #1 Establish a multidisciplinary birth defects research network in Minnesota Objective 1a: Establish a birth defects research network within MDH by the end of 2012 Newborn Screening program Environmental Public Health Tracking Objective 1b: Establish a statewide multidisciplinary birth defects research network in Minnesota by the end of 2014 If you are interested in getting involved in the planning, please let us know today.

30 RESEARCH GOAL #2 Establish an infrastructure and framework to facilitate the use of Minnesota birth defects data in research. Objective 2a: Establish a process for researchers to apply to use birth defects data by June 30, 2013 Objective 2b: Establish a process for reviewing and approving or declining research projects that seek to use birth defects data by June 30, 2013 Objective 2c: Establish a process for estimating costs associated with research and a mechanism to recoup these costs by the end of 2013

31 OTHER RESEARCH POSSIBILITIES National Birth Defects Prevention Network (NBDPN) a volunteer-based organization that addresses the issues of birth defects surveillance, research and prevention under one umbrella by maintaining a national network of state and population-based birth defects programs. National Birth Defects Prevention Study (NBDPS) the largest study in the U.S. looking at the causes of birth defects

32 NBDPN: MULTI-STATE COLLABORATIVE PROJECTS NBDPN facilitates collaborative projects that utilize data from state birth defects registries. State Data Committee: Coordinates data use and data sharing Provides and coordinates technical assistance in study design, analysis and publication

33 RECENT NBDPN MULTI-STATE COLLABORATIVE PROJECTS Prevalence at Birth of Cleft Lip With or Without Cleft Palate: Data From the International Perinatal Database of Typical Oral Clefts. Updated national birth prevalence estimates for selected birth defects in the United States, Geocoding capacity of birth defects surveillance programs: results from the National Birth Defects Prevention Network Geocoding Survey Public health projects for preventing the recurrence of neural tube defects in the United States Multistate study of the epidemiology of clubfoot

34 NATIONAL BIRTH DEFECTS PREVENTION STUDY (NBDPS) one of the largest U.S. studies looking at the risk factors for and potential causes of birth defects population-based, case-control study and has been collecting data since 1997 Sites have included: Arkansas, California, Georgia (CDC), Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah. Interviews and cheek cells from both cases (mothers who have had a pregnancy or baby affected by a birth defects) and controls (mothers who had a baby born in the same area/time) NEW NOTE 11/7: please see additional slides at the end of this document with more details on NBDPS from the 2012 National Meeting

35 MINNESOTA MONITORS 46 CONDITIONS: GASTROINTESTINAL, GENITOURINARY Gastrointestinal Biliary Atresia Esophaegeal Atresia Hirschsprung's Disease Pyloric Stenosis Rectal and Large Intestinal Atresia / Stenosis Genitourinary Bladder Exstrophy Hypospadias and Epispadias Obstructive Genitourinary Defect Renal Agenesis / Hypoplasia

36 MINNESOTA MONITORS 46 CONDITIONS: MUSCULAR SKELETAL, ORAL, OTHER Muscular Skeletal Congenital Hip Dislocation Diaphragmatic Hernia Gastroschisis Omphalocele Reduction Deformity: Lower Limbs Reduction Deformity: Upper Limbs Oral Choanal Atresia Cleft Lip and Palate Cleft Palate without Cleft Lip Other Health Conditions Fetal Alcohol Syndrome (FAS)

37 Defect MOST COMMON BIRTH DEFECTS COUNTS AND PREVALENCE RATES FOR HENNEPIN AND RAMSEY COUNTIES, RANKED BY FREQUENCY ( DATA, TOTAL LIVE BIRTHS = 96,859) N Rate per 10,000 live births Total Defects Body System Category Atrial septal defect Cardiovascular Ventricular septal defect Cardiovascular Hypospadias and Epispadias Genitourinary Obstructive genitourinary defect Genitourinary Patent ductus arteriosus Cardiovascular Pyloric stenosis Gastrointestinal Down Syndrome Chromosomal Cleft lip with and without cleft palate Orofacial Pulmonary valve atresia and stenosis Cardiovascular Cleft palate without cleft lip Orofacial

38 OTHER USES OF DATA Planning for implementation of newborn Critical Congenital Heart Disease screening using pulse oximitry Environmental Public Health Tracking program: Birth Defects Data & Measures report

39 ESTIMATED NUMBER OF CASES OF CCHD IN MINNESOTA Critical Congenital Heart Defects Estimated Expected Annual Case Count* Estimated from all cases identified in BDIS, regardless of maternal residence Estimated using rates from Hennepin/Ramsey Counties only, Hypoplastic Left Heart Syndrome Pulmonary Atresia Tetralogy of Fallot Total Anomalous Pulmonary Venous Return N/A N/A Transposition of the Great Arteries Tricuspid Valve Atresia & Stenosis 5 5 Truncus Arteriosus 5 4 Total CCHD, excluding TAPVR * One child may have more than one of these defects and may be counted twice. Total number of children with CCHD, excluding TAPVR Data from MN BDIS

40 Defect MOST COMMON BIRTH DEFECTS COUNTS AND PREVALENCE RATES FOR HENNEPIN AND RAMSEY COUNTIES, RANKED BY FREQUENCY ( DATA, TOTAL LIVE BIRTHS = 96,859) N Rate per 10,000 live births Total Defects Body System Category Atrial septal defect Cardiovascular Ventricular septal defect Cardiovascular Hypospadias and Epispadias Genitourinary Obstructive genitourinary defect Genitourinary Patent ductus arteriosus Cardiovascular Pyloric stenosis Gastrointestinal Down Syndrome Chromosomal Cleft lip with and without cleft palate Orofacial Pulmonary valve atresia and stenosis Cardiovascular Cleft palate without cleft lip Orofacial

41 OTHER USES OF DATA Planning for implementation of newborn Critical Congenital Heart Disease screening using pulse oximitry Environmental Public Health Tracking program: Birth Defects Data & Measures report

42 ESTIMATED NUMBER OF CASES OF CCHD IN MINNESOTA Critical Congenital Heart Defects Estimated Expected Annual Case Count* Estimated from all cases identified in BDIS, regardless of maternal residence Estimated using rates from Hennepin/Ramsey Counties only, Hypoplastic Left Heart Syndrome Pulmonary Atresia Tetralogy of Fallot Total Anomalous Pulmonary Venous Return N/A N/A Transposition of the Great Arteries Tricuspid Valve Atresia & Stenosis 5 5 Truncus Arteriosus 5 4 Total CCHD, excluding TAPVR * One child may have more than one of these defects and may be counted twice. Total number of children with CCHD, excluding TAPVR Data from MN BDIS

43 RESEARCH

44 RESEARCH

45 RESEARCH GOALS AND OBJECTIVES Drafted in spring 2012 Overarching Goal: By the end of 2014, establish a foundation for including Minnesota birth defects surveillance data in ongoing analysis and research on birth defects.

46 RESEARCH GOAL #1 Establish a multidisciplinary birth defects research network in Minnesota Objective 1a: Establish a birth defects research network within MDH by the end of 2012 Newborn Screening program Environmental Public Health Tracking Objective 1b: Establish a statewide multidisciplinary birth defects research network in Minnesota by the end of 2014 If you are interested in getting involved in the planning, please let us know today.

47 RESEARCH GOAL #2 Establish an infrastructure and framework to facilitate the use of Minnesota birth defects data in research. Objective 2a: Establish a process for researchers to apply to use birth defects data by June 30, 2013 Objective 2b: Establish a process for reviewing and approving or declining research projects that seek to use birth defects data by June 30, 2013 Objective 2c: Establish a process for estimating costs associated with research and a mechanism to recoup these costs by the end of 2013

48 Defect MOST COMMON BIRTH DEFECTS COUNTS AND PREVALENCE RATES FOR HENNEPIN AND RAMSEY COUNTIES, RANKED BY FREQUENCY ( DATA, TOTAL LIVE BIRTHS = 96,859) N Rate per 10,000 live births Total Defects Body System Category Atrial septal defect Cardiovascular Ventricular septal defect Cardiovascular Hypospadias and Epispadias Genitourinary Obstructive genitourinary defect Genitourinary Patent ductus arteriosus Cardiovascular Pyloric stenosis Gastrointestinal Down Syndrome Chromosomal Cleft lip with and without cleft palate Orofacial Pulmonary valve atresia and stenosis Cardiovascular Cleft palate without cleft lip Orofacial

49 OTHER USES OF DATA Planning for implementation of newborn Critical Congenital Heart Disease screening using pulse oximitry Environmental Public Health Tracking program: Birth Defects Data & Measures report

50 ESTIMATED NUMBER OF CASES OF CCHD IN MINNESOTA Critical Congenital Heart Defects Estimated Expected Annual Case Count* Estimated from all cases identified in BDIS, regardless of maternal residence Estimated using rates from Hennepin/Ramsey Counties only, Hypoplastic Left Heart Syndrome Pulmonary Atresia Tetralogy of Fallot Total Anomalous Pulmonary Venous Return N/A N/A Transposition of the Great Arteries Tricuspid Valve Atresia & Stenosis 5 5 Truncus Arteriosus 5 4 Total CCHD, excluding TAPVR * One child may have more than one of these defects and may be counted twice. Total number of children with CCHD, excluding TAPVR Data from MN BDIS

51 RESEARCH

52 RESEARCH GOALS AND OBJECTIVES Drafted in spring 2012 Overarching Goal: By the end of 2014, establish a foundation for including Minnesota birth defects surveillance data in ongoing analysis and research on birth defects.

53 RESEARCH GOAL #1 Establish a multidisciplinary birth defects research network in Minnesota Objective 1a: Establish a birth defects research network within MDH by the end of 2012 Newborn Screening program Environmental Public Health Tracking Objective 1b: Establish a statewide multidisciplinary birth defects research network in Minnesota by the end of 2014 If you are interested in getting involved in the planning, please let us know today.

54 RESEARCH GOAL #2 Establish an infrastructure and framework to facilitate the use of Minnesota birth defects data in research. Objective 2a: Establish a process for researchers to apply to use birth defects data by June 30, 2013 Objective 2b: Establish a process for reviewing and approving or declining research projects that seek to use birth defects data by June 30, 2013 Objective 2c: Establish a process for estimating costs associated with research and a mechanism to recoup these costs by the end of 2013

55 OTHER RESEARCH POSSIBILITIES National Birth Defects Prevention Network (NBDPN) a volunteer-based organization that addresses the issues of birth defects surveillance, research and prevention under one umbrella by maintaining a national network of state and population-based birth defects programs. National Birth Defects Prevention Study (NBDPS) the largest study in the U.S. looking at the causes of birth defects

56 RESEARCH

57 RESEARCH GOALS AND OBJECTIVES Drafted in spring 2012 Overarching Goal: By the end of 2014, establish a foundation for including Minnesota birth defects surveillance data in ongoing analysis and research on birth defects.

58 RESEARCH GOAL #1 Establish a multidisciplinary birth defects research network in Minnesota Objective 1a: Establish a birth defects research network within MDH by the end of 2012 Newborn Screening program Environmental Public Health Tracking Objective 1b: Establish a statewide multidisciplinary birth defects research network in Minnesota by the end of 2014 If you are interested in getting involved in the planning, please let us know today.

59 RESEARCH GOAL #2 Establish an infrastructure and framework to facilitate the use of Minnesota birth defects data in research. Objective 2a: Establish a process for researchers to apply to use birth defects data by June 30, 2013 Objective 2b: Establish a process for reviewing and approving or declining research projects that seek to use birth defects data by June 30, 2013 Objective 2c: Establish a process for estimating costs associated with research and a mechanism to recoup these costs by the end of 2013

60 OTHER RESEARCH POSSIBILITIES National Birth Defects Prevention Network (NBDPN) a volunteer-based organization that addresses the issues of birth defects surveillance, research and prevention under one umbrella by maintaining a national network of state and population-based birth defects programs. National Birth Defects Prevention Study (NBDPS) the largest study in the U.S. looking at the causes of birth defects

61 NBDPN: MULTI-STATE COLLABORATIVE PROJECTS NBDPN facilitates collaborative projects that utilize data from state birth defects registries. State Data Committee: Coordinates data use and data sharing Provides and coordinates technical assistance in study design, analysis and publication

62 RECENT NBDPN MULTI-STATE COLLABORATIVE PROJECTS Prevalence at Birth of Cleft Lip With or Without Cleft Palate: Data From the International Perinatal Database of Typical Oral Clefts. Updated national birth prevalence estimates for selected birth defects in the United States, Geocoding capacity of birth defects surveillance programs: results from the National Birth Defects Prevention Network Geocoding Survey Public health projects for preventing the recurrence of neural tube defects in the United States Multistate study of the epidemiology of clubfoot

63 NATIONAL BIRTH DEFECTS PREVENTION STUDY (NBDPS) one of the largest U.S. studies looking at the risk factors for and potential causes of birth defects population-based, case-control study and has been collecting data since 1997 Sites have included: Arkansas, California, Georgia (CDC), Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas, and Utah. Interviews and cheek cells from both cases (mothers who have had a pregnancy or baby affected by a birth defects) and controls (mothers who had a baby born in the same area/time) NEW NOTE 11/7: please see additional slides at the end of this document with more details on NBDPS from the 2012 National Meeting

64 RECENT ANALYSES BY NBDPS Medication Use During Pregnancy Medicine To Ease Morning Sickness and Risk of Birth Defects Treatment With Prescription Painkillers (Opioids) and Birth Defects Clomiphene Citrate and Birth Defects Birth Defects and Acetaminophen Use Smoking and Neural Tube Defects Genital Tract Infections and Birth Defects Caffeine and Selected Birth Defects

65 PREVENTION

66 PREVENTION EFFORTS 2011 CDC 2006 report: Recommendations to Improve Preconception Health and Health Care --- United States Birth defects program identified a need for baseline Minnesota preconception health data Preconception Health in Minnesota data book: PRAMS Coordinator, Women s Health Consultant, MCH Epidemiologist, student worker Used data from both MN PRAMS and BRFSS surveillance systems RFP in spring MCH Section published the first Preconception Health in Minnesota Data Book: conceptiondatabook.pdf

67 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Women s Health Consultant and Birth Defects program developed the Preconception Health in Minnesota RFP Goal: To improve preconception health and care for nonpregnant, reproductive age women in Minnesota, through support of evidencebased preconception health interventions that prevent and/or reduce the risk for birth defects. Two required components: 1. Routine Risk Assessment and Counseling 2. Intervention in one of the following areas: Reproductive Health Reproductive Life Plans Substance Use Alcohol, tobacco and other drugs Nutrition & Weight Folic Acid Obesity/ Overweight Chronic Disease Diabetes Hypertension Teratogenic Medication Management

68 PREVENTION

69 PREVENTION EFFORTS 2011 CDC 2006 report: Recommendations to Improve Preconception Health and Health Care --- United States Birth defects program identified a need for baseline Minnesota preconception health data Preconception Health in Minnesota data book: PRAMS Coordinator, Women s Health Consultant, MCH Epidemiologist, student worker Used data from both MN PRAMS and BRFSS surveillance systems RFP in spring MCH Section published the first Preconception Health in Minnesota Data Book: conceptiondatabook.pdf

70 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Women s Health Consultant and Birth Defects program developed the Preconception Health in Minnesota RFP Goal: To improve preconception health and care for nonpregnant, reproductive age women in Minnesota, through support of evidencebased preconception health interventions that prevent and/or reduce the risk for birth defects. Two required components: 1. Routine Risk Assessment and Counseling 2. Intervention in one of the following areas: Reproductive Health Reproductive Life Plans Substance Use Alcohol, tobacco and other drugs Nutrition & Weight Folic Acid Obesity/ Overweight Chronic Disease Diabetes Hypertension Teratogenic Medication Management

71 PREVENTION

72 PREVENTION EFFORTS 2011 CDC 2006 report: Recommendations to Improve Preconception Health and Health Care --- United States Birth defects program identified a need for baseline Minnesota preconception health data Preconception Health in Minnesota data book: PRAMS Coordinator, Women s Health Consultant, MCH Epidemiologist, student worker Used data from both MN PRAMS and BRFSS surveillance systems RFP in spring MCH Section published the first Preconception Health in Minnesota Data Book: conceptiondatabook.pdf

73 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Women s Health Consultant and Birth Defects program developed the Preconception Health in Minnesota RFP Goal: To improve preconception health and care for nonpregnant, reproductive age women in Minnesota, through support of evidencebased preconception health interventions that prevent and/or reduce the risk for birth defects. Two required components: 1. Routine Risk Assessment and Counseling 2. Intervention in one of the following areas: Reproductive Health Reproductive Life Plans Substance Use Alcohol, tobacco and other drugs Nutrition & Weight Folic Acid Obesity/ Overweight Chronic Disease Diabetes Hypertension Teratogenic Medication Management

74 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Six organizations funded to use evidence-based practice and evaluate outcomes Reproductive life plans Nutrition and obesity, incl. folic acid Grantees: Family Tree, Inc., St. Paul/Ramsey Co., Washington Co., Hennepin County, Greater Twin Cities Metro Area Fillmore-Houston CHB Horizon Community Health Board: Douglas, Pope, Stevens, Grant, and Traverse Mahube Community Council, Inc. (Mahube-Otwa Community Council): Mahnomen, Hubbard, Becker, Ottertail and Wadena Baby's Space: A Place to Grow: Phillip's neighborhood in Minneapolis, Native American population Planned Parenthood Minnesota, North Dakota, South Dakota: Hispanics served at Centro de Salud in South Minneapolis Meeker-McLeod-Sibley Community Health Services Two year grants Projects started after July 2012 Contractor hired to plan/coordinate evaluation

75 SERVICES

76 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Six organizations funded to use evidence-based practice and evaluate outcomes Reproductive life plans Nutrition and obesity, incl. folic acid Grantees: Family Tree, Inc., St. Paul/Ramsey Co., Washington Co., Hennepin County, Greater Twin Cities Metro Area Fillmore-Houston CHB Horizon Community Health Board: Douglas, Pope, Stevens, Grant, and Traverse Mahube Community Council, Inc. (Mahube-Otwa Community Council): Mahnomen, Hubbard, Becker, Ottertail and Wadena Baby's Space: A Place to Grow: Phillip's neighborhood in Minneapolis, Native American population Planned Parenthood Minnesota, North Dakota, South Dakota: Hispanics served at Centro de Salud in South Minneapolis Meeker-McLeod-Sibley Community Health Services Two year grants Projects started after July 2012 Contractor hired to plan/coordinate evaluation

77 SERVICES

78 PREVENTION

79 PREVENTION EFFORTS 2011 CDC 2006 report: Recommendations to Improve Preconception Health and Health Care --- United States Birth defects program identified a need for baseline Minnesota preconception health data Preconception Health in Minnesota data book: PRAMS Coordinator, Women s Health Consultant, MCH Epidemiologist, student worker Used data from both MN PRAMS and BRFSS surveillance systems RFP in spring MCH Section published the first Preconception Health in Minnesota Data Book: conceptiondatabook.pdf

80 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Women s Health Consultant and Birth Defects program developed the Preconception Health in Minnesota RFP Goal: To improve preconception health and care for nonpregnant, reproductive age women in Minnesota, through support of evidencebased preconception health interventions that prevent and/or reduce the risk for birth defects. Two required components: 1. Routine Risk Assessment and Counseling 2. Intervention in one of the following areas: Reproductive Health Reproductive Life Plans Substance Use Alcohol, tobacco and other drugs Nutrition & Weight Folic Acid Obesity/ Overweight Chronic Disease Diabetes Hypertension Teratogenic Medication Management

81 PRECONCEPTION HEALTH IN MINNESOTA GRANT PROGRAM Six organizations funded to use evidence-based practice and evaluate outcomes Reproductive life plans Nutrition and obesity, incl. folic acid Grantees: Family Tree, Inc., St. Paul/Ramsey Co., Washington Co., Hennepin County, Greater Twin Cities Metro Area Fillmore-Houston CHB Horizon Community Health Board: Douglas, Pope, Stevens, Grant, and Traverse Mahube Community Council, Inc. (Mahube-Otwa Community Council): Mahnomen, Hubbard, Becker, Ottertail and Wadena Baby's Space: A Place to Grow: Phillip's neighborhood in Minneapolis, Native American population Planned Parenthood Minnesota, North Dakota, South Dakota: Hispanics served at Centro de Salud in South Minneapolis Meeker-McLeod-Sibley Community Health Services Two year grants Projects started after July 2012 Contractor hired to plan/coordinate evaluation

82 SERVICES

83 LPH NOTIFICATION AND REFERRAL ASSESSMENT SURVEY RESULTS BDMA notified counties of 1,150 children with confirmed birth defects in this period LPH received family s demographic information and child s birth defect diagnoses 75 agencies received notifications LPH key contacts completed surveys about services using an MDH web survey. Surveys were completed for 910 children Residents of 66 counties Response rate: 79%

84 BIRTH DEFECT TYPE LPH key contacts accepted referrals for children with any of the 45 birth defects monitored by BDMA, regardless of severity of condition Survey results were broken out by severity of condition, which eventually resulted in a new tier classification 53% 32% 14% Not complex (-> Tier 0) More severe (-> Tier 1) Severe or Multiple Dx (-> Tier 2)

85 WAS THE BDMA NOTIFICATION THE FIRST TIME LPH LEARNED ABOUT THIS CHILD? All Not complex (-> Tier 0) More severe (-> Tier 1) Severe or Multiple Dx (-> Tier 2) Yes, BDMA was first notification 57% 63% 50% 55% No, LPH already knew of this child/family 43% 37% 50% 45%

86 PRIOR REFERRAL SOURCE TO LPH All Not complex (-> Tier 0) More severe (-> Tier 1) Severe or Multiple Dx (-> Tier 2) Health Care Provider or Hospital County notification of high risk births (Vital Records MDH) Newborn Hearing Screening program notified them <1 Other source Family/parent, WIC, Another county, Head Start, Early Childhood teacher/ecfe, Family Home Visiting, Health plan, Newspaper, MDH Hep B program

87 LPH CONTACTS WITH FAMILIES 35 LPH reported they had contact with 65% of the children s families Not complex (-> Tier 0): 57% More severe (-> Tier 1): 70% Severe or Multiple Dx (-> Tier 2): 68% 65 Contacted No contact

88 REASON GIVEN WHY LPH DID NOT HAVE CONTACT WITH FAMILY All Not complex (-> Tier 0) More severe (-> Tier 1) Severe or Multiple Dx (-> Tier 2) We don t contact for this condition 62% 69% 56% 58% Child moved out of the county 1% 0% 3% <1% Unable to locate family 10% 15% 8% 7% Other reason please specify 27% 17% 33% 34% Write in responses for Other reason: No prior knowledge of child/no prior referral to public health services (problem with response timing) Left telephone message and sent letter, no response Sent letter only, no telephone number avail, no response HMG EI open

89 PROGRAMS & SERVICES USED Service/Program Yes No Not applicable/n ot eligible I don t have access to this information WIC 35% 24% 7% 34% Follow Along Program 26% 50% 6% 18% Family Home Visiting 24% 61% 1% 14% Help Me Grow/Part C 30% 25% 3% 42% MA/MN Care 39% 22% 8% 31% Social Security Disability 7% 21% 7% 64% Some variation by severity of condition, e.g. children with less severe conditions had low reported participation in Help Me Grow/Part C: 12% Accessing information was a big factor for some types of services (WIC, Part C, SSI, MA/MNCare)

90 MEDICAL/INTERPRETER SERVICES Service/Program Yes No I don t have access to this information Health Care Home 62% 8% 30% Primary Care Provider 55% 0% 44% Interpreter n/a 96% 4% Interpreter services Provided in person and by phone Spanish (17), Somali (9), Hmong (2), Russian, Korean, Nepali, deaf/hard of hearing

91 OTHER PROGRAMS FAMILIES ARE USING (WRITE-IN) Car seat Child Protective Services Children s Hospital One-time home visit, not on-going FHV program Down Syndrome Support Group ECFE Early Intervention Physical Therapy Occupational Therapy Energy Assistance Program Salvation Army Genetic Evaluation Speech therapy Deaf and Hard of Hearing Services MOPS Skilled Nurse visits PCA assessment Informal mom s group Respite plan Comments included programs parents were referred to but did not participate or was not eligible: TEFRA, FHV, Follow Along, WIC, Help Me Grow

92 QUESTIONS? Contacts: Barbara Frohnert Jan Sieger Kris Peterson Oehlke

93 BIRTH DEFECTS RESEARCH WHAT S HAPPENING NATIONALLY NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING National Birth Defects Prevention Study-NBDPS largest population-based case control study done in US aim to ID genetic and environmental risk factors for 30 selected birth defects looks at birth defects of unknown etiology Started collecting data for October 1997 births To date over 41,000 women interviewed

94 NBDPS STUDY CENTERS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING

95 NBDPS DATA COLLECTION STEPS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Step 1: Cases identified from enhanced birth defects surveillance systems Step 2: Controls selected from hospital or vital records Step 3: Information packet sent out to mother Step 4: Telephone interview with mother Step 5: Buccal collection (baby, mother, father) Step 6: Mothers get yearly NBDPS newsletter

96 STUDY PARTICIPANTS: CASES NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Around 3500 cases interviewed each year Standard, detailed case definitions used Clinical geneticists review case records Each specific defect category classified by the same geneticist Heart defects are assigned to a single diagnostic category by pediatric cardiologists

97 STUDY PARTICIPANTS: CONTROLS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Random sample of 1200 live-born infants/yr Selected from birth certs or birth hospitals in the same geographic region as case No major birth defects

98 NBDPS INTERVIEW PROTOCOL NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Maternal Interview Computer-assisted telephone interview Conducted from 6 weeks to up to 2 years after delivery Offered in English or Spanish Participation among cases is ~70% Participation among controls is ~67%

99 NBDPS BIOLOGIC SPECIMENS COLLECTED NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Buccal Cell Collection Self-collection using cytobrushes Two cytobrushes each for infant, mother, father odna from one brush remains at the local site odna from the other brush is sent to central repository Participation among cases is ~ 56% Participation among controls is ~ 50%

100 NBDPS QUESTIONAIRE TOPICS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Exposure time period from 3 months before (b3) to end of pregnancy (P9) Pregnancy history Maternal disease (hypertension, seizures, diabetes, respiratory infection, other chronic) Meds used for those chronic diseases, and All medications taken listed by name Use of vitamins and herbals

101 NBDPS QUESTIONNAIRE TOPICS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Food frequency questionnaire for year before pregnancy Maternal and paternal occupations Places of residence Maternal smoking, alcohol and drug use Family history Demographics Stress Physical activity

102 NBDPS ANALYTICAL DATABASE MOST RECENT ( ) CONTAINS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Controls 8494 Spina bifida 941 Dandy-Walker malformation 130 Tetralogy of Fallot 886 Ebstein anomaly 124 N = Cleft lip with or without cleft palate 2283 Hypospadias 1697 Craniosynostosis 1072 Gastroschisis 972 N =

103 STRENGTHS OF NBDPS NOTE: THIS SLIDE IS FROM A PRESENTATION FROM THE NBDPN/NBDPS 2012 NATIONAL MEETING Population-based study Ability to assess individual birth defects because of large sample size Very clear case definition Includes information about environmental exposures Biologic samples available for infant, mother and father

BIRTH DEFECTS IN MICHIGAN All Cases Reported and Processed by April 15, 2008

BIRTH DEFECTS IN MICHIGAN All Cases Reported and Processed by April 15, 2008 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Division for Vital Records and Health Statistics MICHIGAN BIRTH DEFECTS SURVEILLANCE REGISTRY BIRTH DEFECTS IN MICHIGAN All Cases Reported and Processed by April

More information

The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb.

The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb. The Patterns and Public Health Impact of Heart Defects in Texas Pediatric Cardiac Care Conference VI Dell Children s Medical Center, Feb. 7-8, 2013 Mark Canfield, Ph.D. Manager, Birth Defects Epidemiology

More information

Population prevalence rates of birth defects: a data management and epidemiological perspective

Population prevalence rates of birth defects: a data management and epidemiological perspective Population prevalence rates of birth defects: a data management and epidemiological perspective Merilyn Riley Abstract The Victorian Birth Defects Register (VBDR) is a population-based surveillance system

More information

Trends in the Prevalence of Birth Defects in Illinois and Chicago 1989-2009

Trends in the Prevalence of Birth Defects in Illinois and Chicago 1989-2009 State of Illinois Illinois Department of Public Health Trends in the Prevalence of Birth Defects in Illinois and Chicago 1989-2009 Epidemiologic Report Series 12:04 November 2012 TRENDS IN THE PREVALENCE

More information

Exploring the Seasonality of Birth Defects in the New York State Congenital Malformations Registry

Exploring the Seasonality of Birth Defects in the New York State Congenital Malformations Registry Ó 2012 Wiley Periodicals, Inc. Exploring the Seasonality of Birth Defects in the New York State Congenital Malformations Registry Alissa R. Caton* University at Albany, Department of Epidemiology and Biostatistics,

More information

Birth Defects in Connecticut 2001-2004

Birth Defects in Connecticut 2001-2004 Birth Defects in Connecticut 2001-2004 A Surveillance Report on Birth Defects Prevalence Connecticut Department of Public Health Public Health Initiatives Branch Family Health Section Connecticut Birth

More information

Maine CDC Birth Defects Program

Maine CDC Birth Defects Program Maine CDC Birth Defects Program January 1, 2011- December 31, 2011 Submitted to the Joint Standing Committee on Health and Human Services 2011 Annual Report Table of Contents Executive Summary 3 Maine

More information

Monitoring Infants and Children with Special Health Needs

Monitoring Infants and Children with Special Health Needs Monitoring Infants and Children with Special Health Needs Birth Defects Prevalence and Mortality in Michigan, 1992-2008 A report prepared by Michigan Department of Community Health Bureau of Disease Control,

More information

The Newborn With a Congenital Disorder. Chapter 14. Copyright 2008 Wolters Kluwer Health Lippincott Williams & Wilkins

The Newborn With a Congenital Disorder. Chapter 14. Copyright 2008 Wolters Kluwer Health Lippincott Williams & Wilkins The Newborn With a Congenital Disorder Chapter 14 Congenital Anomalies or Malformations May be caused by genetic or environmental factors Approximately 2% to 3% of all infants born have a major malformation

More information

Facts about Congenital Heart Defects

Facts about Congenital Heart Defects Facts about Congenital Heart Defects Joseph A. Sweatlock, Ph.D., DABT New Jersey Department of Health Early Identification & Monitoring Program Congenital heart defects are conditions that are present

More information

NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04. Chapter 5 Classification and Coding

NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04. Chapter 5 Classification and Coding Chapter 5 Classification and Coding Table Contents 5.1 Introduction... 5-1 5.2 Disease Classification Systems... 5-2 5.2.1 Description and Format... 5-2 5.2.2 ICD-9-CM and the 6-digit CDC Code A Comparison...

More information

Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being

Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Universal Fetal Cardiac Ultrasound At the Heart of Newborn Well-being Optimizes detection of congenital heart disease (chd) in the general low risk obstetrical population Daniel J. Cohen, M.D. danjcohen@optonline.net

More information

Influences on Birth Defects

Influences on Birth Defects Influences on Birth Defects FACTS About 150,000 babies are born each year with birth defects. The parents of one out of every 28 babies receive the frightening news that their baby has a birth defect There

More information

RHODE ISLAND BIRTH DEFECTS DATA BOOK 2014

RHODE ISLAND BIRTH DEFECTS DATA BOOK 2014 RHODE ISLAND BIRTH DEFECTS DATA BOOK 2014 INTRODUCTION What are Birth Defects? Birth defects are structural abnormalities that affect the development of organs and tissues of an infant or child. These

More information

North Dakota Birth Defects Monitoring System

North Dakota Birth Defects Monitoring System North Dakota Birth Defects Monitoring System Summary Report 1995-1999 North Dakota Department of Health North Dakota Birth Defects Monitoring System Summary Report 1995 1999 John Hoeven, Governor Dr. Terry

More information

MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Division for Vital Records and Health Statistics Michigan Birth Defects Registry

MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Division for Vital Records and Health Statistics Michigan Birth Defects Registry MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES Division for Vital Records and Health Statistics Michigan Birth Defects Registry BIRTH DEFECTS IN MICHIGAN All Cases Reported and Processed by April 30, 2014

More information

A Strategic Plan for Improving Preconception Health and Health Care: Recommendations from the CDC Select Panel on Preconception Care

A Strategic Plan for Improving Preconception Health and Health Care: Recommendations from the CDC Select Panel on Preconception Care 1 A Strategic Plan for Improving Preconception Health and Health Care: Recommendations from the CDC Select Panel on Preconception Care Presentation by Kay A. Johnson, MPH, EdM Research Assistant Professor,

More information

How to get insurance companies to work with you

How to get insurance companies to work with you Paying for Quality ACHD Care How to get insurance companies to work with you Christy Sillman, RN, MSN ACHD nurse coordinator Inpatient ACHD Nurse Educator The Adult Congenital Heart Program Stanford Lucile

More information

A N N U A L R E P O R T

A N N U A L R E P O R T Alberta Congenital Anomalies Surveillance System 1980-2001 A N N U A L R E P O R T ALBERTA CONGENITAL ANOMALIES SURVEILLANCE SYSTEM SIXTH REPORT 1980 2001 Alberta Children s Hospital Research Centre Department

More information

Common types of congenital heart defects

Common types of congenital heart defects Common types of congenital heart defects Congenital heart defects are abnormalities that develop before birth. They can occur in the heart's chambers, valves or blood vessels. A baby may be born with only

More information

Focus: Children and Youth With Special Health Care Needs (CYSHCN) Children & Youth With Developmental Delays

Focus: Children and Youth With Special Health Care Needs (CYSHCN) Children & Youth With Developmental Delays Focus: Children and Youth With Special Health Care Needs (CYSHCN) Children & Youth With Developmental Delays "The early years of a child's life are crucial for cognitive, social and emotional development.

More information

EUROCAT Statistical Monitoring Report 2009

EUROCAT Statistical Monitoring Report 2009 EUROCAT Statistical Monitoring Report 2009 (Uploaded to EUROCAT website January 2012) EUROCAT Central Registry University of Ulster Newtownabbey, Co Antrim Northern Ireland, BT37 0QB Tel: +44 28 9036 6639

More information

Workshop B: Essentials of Neonatal Cardiology and CHD Anthony C. Chang, MD, MBA, MPH CARDIAC INTENSIVE CARE

Workshop B: Essentials of Neonatal Cardiology and CHD Anthony C. Chang, MD, MBA, MPH CARDIAC INTENSIVE CARE SHUNT LESIONS NEONATAL : CONGENITAL CARDIAC MALFORMATIONS AND CARDIAC SURGERY ANTHONY C. CHANG, MD, MBA, MPH CHILDREN S HOSPITAL OF ORANGE COUNTY ATRIAL SEPTAL DEFECT LEFT TO RIGHT SHUNT INCREASED PULMONARY

More information

MISSISSIPPI STATE DEPARTMENT OF HEALTH

MISSISSIPPI STATE DEPARTMENT OF HEALTH MISSISSIPPI STATE DEPARTMENT OF HEALTH Birth Defects Surveillance Report 2000 2007 Beryl W. Polk, PhD, MS, CPM Director, Genetic Services AUTHORS AND CONTRIBUTORS Ninglong Han, MS Biostatician, Office

More information

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010 Extended MPH Degree Program School of Public Health Department of Epidemiology University of Washington Epidemiology 521 Epidemiology of Maternal and Child Health Problems Winter / Spring, 2010 Instructor:

More information

Birth Defects Prevalence and Mortality in Michigan, 1992-2002

Birth Defects Prevalence and Mortality in Michigan, 1992-2002 Monitoring Infants and Children with Special Health Needs Birth Defects Prevalence and Mortality in Michigan, 1992-2002 March 2005 For more information or to request additional copies of this report: (517)

More information

The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography

The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography Bahrain Medical Bulletin, Vol. 36, No. 2, June 2014 ABSTRACT The Pattern of Congenital Heart Disease among Neonates Referred for Echocardiography Hussain Al Khawahur, MD* Hussain Al Sowaiket, MD** Thuria

More information

Congenital Anomalies In Diamond Blackfan Anemia (DBA)

Congenital Anomalies In Diamond Blackfan Anemia (DBA) Congenital Anomalies In Diamond Blackfan Anemia (DBA) CS217857 National Center on Birth Defects and Developmental Disabilities Division of Blood Disorders Congenital Anomalies In Diamond Blackfan Anemia

More information

Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn

Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn Screening for Critical Congenital Heart Disease in the Apparently Healthy Newborn A presentation of Texas Pulse Oximetry Project: A Joint Educational Initiative of The University of Texas Health Science

More information

Date of Birth Contact No Occupation

Date of Birth Contact No Occupation Reg. No 199002477Z PRUMUM2BE CLAIM FORM CEREBRAL PALSY SECTION 1 This section is to be completed by the Life Assured who is at least 18 years old or the policyowner if the Life Assured is below 18 years

More information

We understand you want to protect your child before he is born

We understand you want to protect your child before he is born PROTECT We understand you want to protect your child before he is born PRUfirst gift The First Gift that Begins from Within The first of its kind in Singapore, PRUfirst gift provides guaranteed protection

More information

Graduate Student Epidemiology Program

Graduate Student Epidemiology Program Graduate Student Epidemiology Program To promote training in MCH Epidemiology Real-World Experience in: Data Analysis and Monitoring Needs Assessment Program Evaluation 2015 Program Guide Submit your application

More information

Health Reform Minnesota. Health Care Home Care Coordination Tiering-Billing Workshop October 1, 2014

Health Reform Minnesota. Health Care Home Care Coordination Tiering-Billing Workshop October 1, 2014 Health Reform Minnesota Health Care Home Care Coordination Tiering-Billing Workshop October 1, 2014 Objectives Gain a better understanding of how to use the HCH Care Coordination Tier Assignment tool for

More information

Facts about Cleft Palate (CP) 1994-2004, Arizona

Facts about Cleft Palate (CP) 1994-2004, Arizona 1994-2004, Arizona Arizona Birth Defects Monitoring Program (ABDMP) 150 N. 18th Ave, Suite 550 Phoenix, AZ 85007-3248 Phone: 602-364-1302 Fax: 602-542-7447 E-mail: texc@azdhs.gov Definition and Types Cleft

More information

Preconception Clinical Care for Women Medical Conditions

Preconception Clinical Care for Women Medical Conditions Preconception Clinical Care for Women All women of reproductive age are candidates for preconception care; however, preconception care must be tailored to meet the needs of the individual. Given that preconception

More information

Birth Defects in Kettleman City

Birth Defects in Kettleman City Birth Defects in Kettleman City One in every 33 babies is born with a birth defect, including structural defects, metabolic disorders, and some types of developmental disabilities. For this reason, California

More information

Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health

Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health Describe local trends in birth Identify 3 perinatal health problems Identify 3 leading causes of infant death Age Class

More information

Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health

Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health 1 Biostatistics Statistical Methods & Theory Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health General Public Health Epidemiology Risk Assessment Population-Based

More information

Transition to Use of ICD-10-CM Coding for Birth Defects, Part 3

Transition to Use of ICD-10-CM Coding for Birth Defects, Part 3 Transition to Use of ICD-10-CM Coding for Birth Defects, Part 3 Janet Cragan, MD MPH NBDPN Guidelines and Standards Committee December 4, 2014 National Center on Birth Defects and Developmental Disabilities

More information

Graduate Student Internship Program

Graduate Student Internship Program Maternal and Child Health Information Resource Center Graduate Student Internship Program To promote training in MCH Epidemiology Real-World Experience in: Data Analysis and Monitoring Needs Assessment

More information

Chapter 6 Case Ascertainment Methods

Chapter 6 Case Ascertainment Methods Chapter 6 Case Ascertainment Methods Table of Contents 6.1 Introduction...6-1 6.2 Terminology...6-2 6.3 General Surveillance Development...6-4 6.3.1 Plan and Document... 6-4 6.3.2 Identify Data Sources...

More information

On behalf of the Association of Maternal and Child Health Programs (AMCHP), I am

On behalf of the Association of Maternal and Child Health Programs (AMCHP), I am Christopher Kus, M.D., M.P.H. Association of Maternal and Child Health Programs, Public Witness Testimony House Labor, Health and Human Services and Education Appropriations Subcommittee March 13, 2013

More information

Chromosome Syndromes associated with Congenital Heart Defects

Chromosome Syndromes associated with Congenital Heart Defects National Birth Defects Prevention Network (NBPDN)/NBDPS Annual Meeting Feb. 26-29. 2012 Arlington, VA Chromosome Syndromes associated with Congenital Heart Defects Angela E. Lin, MD, FAAP, FACMG Associate

More information

Facts about Diabetes in Massachusetts

Facts about Diabetes in Massachusetts Facts about Diabetes in Massachusetts Diabetes is a disease in which the body does not produce or properly use insulin (a hormone used to convert sugar, starches, and other food into the energy needed

More information

Nutrition in Paediatric Cardiology. Karen Hayes Paediatric Dietitian Addenbrooke s Hospital

Nutrition in Paediatric Cardiology. Karen Hayes Paediatric Dietitian Addenbrooke s Hospital Nutrition in Paediatric Cardiology Karen Hayes Paediatric Dietitian Addenbrooke s Hospital Topics Who needs Nutrition support? Energy Requirements Meeting Energy and growth requirements Feeding Issues

More information

Pregnancy and Substance Abuse

Pregnancy and Substance Abuse Pregnancy and Substance Abuse Introduction When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you put into your

More information

TITLE V OF THE SOCIAL SECURITY ACT MATERNAL AND CHILD HEALTH INFANT MORTALITY EFFORTS

TITLE V OF THE SOCIAL SECURITY ACT MATERNAL AND CHILD HEALTH INFANT MORTALITY EFFORTS TITLE V OF THE SOCIAL SECURITY ACT MATERNAL AND CHILD HEALTH INFANT MORTALITY EFFORTS Michele H. Lawler, M.S., R.D. Department of Health and Human Services Health Resources and Services Administration

More information

PUBLIC HEALTH IMPROVEMENT PARTNERSHIP

PUBLIC HEALTH IMPROVEMENT PARTNERSHIP PUBLIC HEALTH IMPROVEMENT PARTNERSHIP PUBLIC HEALTH ACTIVITIES & SERVICES INVENTORY TECHNICAL NOTES HEALTHY FAMILY DEVELOPMENT Nurse-Family Partnership Nurse-Family Partnership is a voluntary program of

More information

FAMILY HEALTH SERVICES DIVISION Profiles 2014 OVERVIEW

FAMILY HEALTH SERVICES DIVISION Profiles 2014 OVERVIEW FAMILY HEALTH SERVICES DIVISION Profiles 2014 OVERVIEW Family Health Services Division Overview Data Sources Life Course Perspective and Title V Priorities Population Overview Births Infant Mortality Chapter

More information

Birth defects. Report by the Secretariat

Birth defects. Report by the Secretariat EXECUTIVE BOARD EB126/10 126th Session 3 December 2009 Provisional agenda item 4.7 Birth defects Report by the Secretariat 1. In May 2009 the Executive Board at its 125th session considered an agenda item

More information

CONGENITAL HEART DISEASE

CONGENITAL HEART DISEASE CONGENITAL HEART DISEASE Introduction Congenital heart disease (CHD) is the most common congenital disorder in newborns [1]. Due to definitional issues, there are large variations in prevalence estimates.

More information

Disclosures. Not as Pink as You Think 3/17/2014. Not As Pink As You Think: Pulse Oximetry Screening For Critical Congenital Heart Disease

Disclosures. Not as Pink as You Think 3/17/2014. Not As Pink As You Think: Pulse Oximetry Screening For Critical Congenital Heart Disease March of Dimes New York State Chapter 36th Annual Perinatal Nurses Conference Promoting Perinatal Health Through Evidence Based Practice Not As Pink As You Think: Pulse Oximetry Screening For Critical

More information

Graduate Student Epidemiology Program

Graduate Student Epidemiology Program Graduate Student Epidemiology Program To promote training in MCH Epidemiology Real-World Experience in: Data Analysis and Monitoring Needs Assessment Program Evaluation 2014 Program Guide Submit your application

More information

Maternal Multivitamin Use and Infant Cardiac Defects

Maternal Multivitamin Use and Infant Cardiac Defects American Journal of Epidemiology Copyright by The Johns Hopkins University School of Hygiene and Public Health All rights reserved Vol., 9 Printed in U.S.A. ORIGINAL CONTRIBUTIONS Occurrence of Congenital

More information

CMS CLINICAL ELIGIBILITY ATTESTATION

CMS CLINICAL ELIGIBILITY ATTESTATION CMS CLINICAL ELIGIBILITY ATTESTATION Patient Name: DOB: Medicaid and/or KidCare ID: Parent/Legal Guardian Name: Phone number: Initial all that Apply: Initials ICD 10 Descriptor Certain infectious and parasitic

More information

Graduate Student Epidemiology Program

Graduate Student Epidemiology Program Graduate Student Epidemiology Program To promote training in MCH Epidemiology Real-World Experience in: Data Analysis and Monitoring Needs Assessment Program Evaluation 2016 Program Guide Submit your application

More information

Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy

Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy Methodology for Safety Surveillance of Adverse Events Following Vaccination During Pregnancy C. Jouquelet-Royer September 2012 Fondation Merieux NAME OF PRESENTATION 1 Presentation Outline Background Company

More information

Birth Defects Monitoring in Japan -Possible Effects of Environmental Endocrine Disrupters-

Birth Defects Monitoring in Japan -Possible Effects of Environmental Endocrine Disrupters- Birth Defects Monitoring in Japan -Possible Effects of Environmental Endocrine Disrupters- Fumiki Hirahara Yokohama City University School of Medicine Thank you, Paul. It is my great pleasure to be here

More information

Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General

Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General Florida Department of Health Division of Disease Control Bureau of Epidemiology Chronic Disease Epidemiology Section Charlie Crist Governor Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General Florida

More information

Genomics and Family History Survey Questions Updated March 2007 Compiled by the University of Washington Center for Genomics & Public Health

Genomics and Family History Survey Questions Updated March 2007 Compiled by the University of Washington Center for Genomics & Public Health Genomics and Survey Questions Updated March 2007 Compiled by the University of Washington Center for Genomics & Public Health This publication is distributed free of charge and supported by CDC Grant #U10/CCU025038-2.

More information

23. TERATOGENS AND THEIR EFFECTS

23. TERATOGENS AND THEIR EFFECTS 23. TERATOGENS AND THEIR EFFECTS Wendy Chung, M.D. Ph.D. Telephone: 851-5313 e-mail: wkc15@columbia.edu SUMMARY A congenital malformation is an anatomical or structural abnormality present at birth. Congenital

More information

Birth Defects Tracking and Prevention: Too Many States Are Not Making the Grade. Trust for America's Health 2002

Birth Defects Tracking and Prevention: Too Many States Are Not Making the Grade. Trust for America's Health 2002 Birth Defects Tracking and Prevention: Too Many States Are Not Making the Grade Trust for America's Health 2002 Trust for America's Health (www.healthyamericans.org) Trust for America's Health (TFAH) is

More information

Genetic Aspects of Mental Retardation and Developmental Disabilities

Genetic Aspects of Mental Retardation and Developmental Disabilities Prepared by: Chahira Kozma, MD Associate Professor of Pediatrics Medical Director/DCHRP Kozmac@georgetown.edu cck2@gunet.georgetown.edu Genetic Aspects of Mental Retardation and Developmental Disabilities

More information

Critical Congenital Heart Disease (CCHD) Screening

Critical Congenital Heart Disease (CCHD) Screening Critical Congenital Heart Disease (CCHD) Screening Screening The Florida Genetics and Newborn Screening Advisory Council recommended to the Department of Health that CCHD be added to the panel of disorders

More information

Date of Birth Contact No Occupation

Date of Birth Contact No Occupation PRUSMART LADY CLAIM FORM (CEREBRAL PALSY) SECTION 1 This section is to be completed by the Life Assured who is at least 18 years old or the policyowner if the Life Assured is below 18 years old The issue

More information

12. MATERNAL, INFANT, AND CHILD HEALTH

12. MATERNAL, INFANT, AND CHILD HEALTH 12. MATERNAL, INFANT, AND CHILD HEALTH Goal Improve maternal health and pregnancy outcomes and reduce the rate of disability in infants, thereby improving the health and well being of women, infants, children,

More information

Oregon s Strategic Plan for Genetics and Public Health

Oregon s Strategic Plan for Genetics and Public Health Oregon s Strategic Plan for Genetics and Public Health November 2002 Supported by a grant from the Maternal and Child Health Bureau Grant # 4 H46 MC 00172-02-1 Introduction to Oregon s Strategic Plan for

More information

Prenatal screening and diagnostic tests

Prenatal screening and diagnostic tests Prenatal screening and diagnostic tests Contents Introduction 3 First trimester routine tests in the mother 3 Testing for health conditions in the baby 4 Why would you have a prenatal test? 6 What are

More information

THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS

THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS MEDICAL CENTER ARCHIVES OF NEWYORK-PRESBYTERIAN/WEILL CORNELL 1300 York Avenue # 34 New York, NY 10065 Finding Aid To THE MARY ALLEN ENGLE, MD (1922-2008) PAPERS Dates of Papers: 1948-1991 52.5 Linear

More information

Genetic Counseling: A Profession in the Making. Jessica Hooks, MS Genetic Counselor University of South Carolina

Genetic Counseling: A Profession in the Making. Jessica Hooks, MS Genetic Counselor University of South Carolina Genetic Counseling: A Profession in the Making Jessica Hooks, MS Genetic Counselor University of South Carolina Definition the process of helping people understand and adapt to the medical, psychological

More information

Meena Abraham, DrPH, MPH Director of Epidemiology Services Baltimore City Health Department

Meena Abraham, DrPH, MPH Director of Epidemiology Services Baltimore City Health Department Meena Abraham, DrPH, MPH Director of Epidemiology Services Baltimore City Health Department 271 Neighborhood Statistical Areas 55 Community Statistical Areas 26 Zip Codes Characteristic Baltimore City

More information

CCHD Screening in Maryland - Year 1 Results APHL NBSGTS Meeting October 29, 2014, Anaheim CA

CCHD Screening in Maryland - Year 1 Results APHL NBSGTS Meeting October 29, 2014, Anaheim CA CCHD Screening in Maryland - Year 1 Results APHL NBSGTS Meeting October 29, 2014, Anaheim CA Debbie Badawi, MD and Johnna Watson, RN, BSN Office for Genetics and People with Special Health Care Needs Maryland

More information

Non-covered ICD-10-CM Codes for All Lab NCDs

Non-covered ICD-10-CM Codes for All Lab NCDs Non-covered ICD-10-CM s for All Lab NCDs This section lists codes that are never covered by Medicare for a diagnostic lab testing service. If a code from this section is given as the reason for the test,

More information

Toolkit for Implementation of Pulse Oximetry Screening for Critical Congenital Heart Disease

Toolkit for Implementation of Pulse Oximetry Screening for Critical Congenital Heart Disease Toolkit for Implementation of Pulse Oximetry Screening for Critical Congenital Heart Disease 2 Table of Contents About CCHD CCHD and pulse oximetry screening... 3 CCHD Screening Protocol... 4 Equipment

More information

Screening for Critical Congenital Heart Disease in Newborns Using Pulse Oximetry Role for a Birth Defect Registry

Screening for Critical Congenital Heart Disease in Newborns Using Pulse Oximetry Role for a Birth Defect Registry Screening for Critical Congenital Heart Disease in Newborns Using Pulse Oximetry Role for a Birth Defect Registry Leslie M. Beres-Sochka, MS Hyg Lori Freed Garg, MD, MPH New Jersey Department of Health

More information

Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD

Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD Working Towards Neonatal Pulse Oximetry Screening to Detect Critical CHD Dalhousie Fall Refresher Course 2015 Kenny K Wong, MD, FRCPC Pediatric Cardiologist Associate Professor of Pediatrics Objectives

More information

Congenital Diaphragmatic Hernia By Dr. N. Robert Payne

Congenital Diaphragmatic Hernia By Dr. N. Robert Payne The following material was developed prior to RGA s acquisition on January 1, 2010 of the Group Reinsurance Business formerly formerly owned owned by ReliaStar by Life ReliaStar Insurance Life Company

More information

SOFT Surgery Summary Table: Scroll down to see all entries and the footnotes.

SOFT Surgery Summary Table: Scroll down to see all entries and the footnotes. SOFT Surgery Summary Table: Scroll down to see all entries and the footnotes. SURGERY T13 T13MOS T18 T18MOS Other Totals CARDIAC: AORTA WIDENED/ANGIOPLASTY/RECONSTRUCTION 0 0 1 0 1 2 CARDIAC: AORTIC COARCTATION

More information

9/8/2014 EPIDEMIOLOGY PUBLIC HEALTH INTERVENTIONS FOR NEONATAL ABSTINENCE SYNDROME DISCLOSURE OBJECTIVES. No financial COI to disclose

9/8/2014 EPIDEMIOLOGY PUBLIC HEALTH INTERVENTIONS FOR NEONATAL ABSTINENCE SYNDROME DISCLOSURE OBJECTIVES. No financial COI to disclose PUBLIC HEALTH INTERVENTIONS FOR NEONATAL ABSTINENCE SYNDROME DISCLOSURE No financial COI to disclose Eric Reynolds MD MPH OBJECTIVES To discuss the epidemiology and current scope of the Neonatal Abstinence

More information

About the Lactation Consultant Education Program

About the Lactation Consultant Education Program About the Lactation Consultant Education Program Oklahoma State University-Oklahoma City (OSU-OKC) offers continuing education courses that encourage participants to customize their self-directed study

More information

Congenital heart defects

Congenital heart defects CONGENITAL ANOMALY REGISTER & INFORMATION SERVICE COFRESTR ANOMALEDDAU CYNHENID Congenital heart defects Cardiovascular defects are by far the commonest major group of congenital anomalies. Development

More information

CCS - Does CCS provide Counseling or Support Services? CCS - Are there any costs to me? CCS - What papers should I bring?

CCS - Does CCS provide Counseling or Support Services? CCS - Are there any costs to me? CCS - What papers should I bring? CCS - Does CCS provide Counseling or Support Services? CCS - Are there any costs to me? CCS - What papers should I bring? CCS - What are the steps to CCS services? CCS - How is my privacy protected? CCS

More information

Important facts to remember

Important facts to remember Important facts to remember If you re pregnant or trying to get pregnant, or if you know someone who is, there are several important points to remember: See a healthcare professional regularly. Get plenty

More information

Data validation and Data sources

Data validation and Data sources British Isles Network of Congenital Anomaly Registers BINOCAR Standard Operating Procedure for Data validation and Data sources Instructions for the Registration and Surveillance of Congenital Anomalies

More information

Public Health Nurse Home Visiting Frequently Asked Questions When did nurse home visiting begin?

Public Health Nurse Home Visiting Frequently Asked Questions When did nurse home visiting begin? Public Health Nurse Home Visiting Frequently Asked Questions When did nurse home visiting begin? Home visiting became a national public health strategy to improve the health status of women and children

More information

Develop strategies to increase provider participation.

Develop strategies to increase provider participation. Critical Component: Access to Health Insurance and Medical Homes Goal 1: Comprehensive Medical Home for Mother and Child * A. Increase the percentage of mothers and children 0-5 who have access to a medical

More information

Hazard v Outrage Birth Defects in New Plymouth. Barry Borman Associate Director Centre for Public Health Research Massey University - Wellington

Hazard v Outrage Birth Defects in New Plymouth. Barry Borman Associate Director Centre for Public Health Research Massey University - Wellington Hazard v Outrage Birth Defects in New Plymouth Barry Borman Associate Director Centre for Public Health Research Massey University - Wellington Gorse A major weed in New Zealand introduced from England

More information

Cardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 Page

Cardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 Page Cardiology Fellowship Manual Goals & Objectives -Cardiac Imaging- 1 Page 2015-2016 UNIV. OF NEBRASKA CHILDREN S HOSPITAL & MEDICAL CENTER DIVISION OF CARDIOLOGY FELLOWSHIP PROGRAM CARDIAC IMAGING ROTATION

More information

Selected Health Status Indicators DALLAS COUNTY. Jointly produced to assist those seeking to improve health care in rural Alabama

Selected Health Status Indicators DALLAS COUNTY. Jointly produced to assist those seeking to improve health care in rural Alabama Selected Health Status Indicators DALLAS COUNTY Jointly produced to assist those seeking to improve health care in rural Alabama By The Office of Primary Care and Rural Health, Alabama Department of Public

More information

Measuring Childhood Obesity: Public Health Surveillance OR School-based Screening and Parent Notification?

Measuring Childhood Obesity: Public Health Surveillance OR School-based Screening and Parent Notification? Measuring Childhood Obesity: Public Health Surveillance OR School-based Screening and Parent Notification? Minnesota Department of Health Martha Roberts, MPH March 24, 2008, 10:00-11:30 AM University of

More information

Substance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates

Substance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates Substance Abuse During Pregnancy: Moms on Meds Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates 2010 National Survey on Drug Use and Health An estimated 4.4% of pregnant women reported

More information

Definition of Foundational Public Health Services

Definition of Foundational Public Health Services Definition of Foundational Public Health Services FOUNDATIONAL CAPABILITIES A. Assessment (Surveillance and Epidemiology). The foundational definition of this capability includes: 1. Ability to collect

More information

Feeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014

Feeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Feeding in Infants with Complex Congenital Heart Disease Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Objectives Discuss common feeding issues in patients with

More information

Maternal, Infant, Child Health Report:

Maternal, Infant, Child Health Report: Maternal, Infant, Child Health Report: Exploring the health status of mothers living in the Cypress Health Region & their children EXECUTIVE SUMMARY Introduction The first six years of a child s life are

More information

Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities

Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities Original article Arch Argent Pediatr 2013;111(5):418-422 / 418 Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities

More information

Wisconsin Birth Defects Registry

Wisconsin Birth Defects Registry 2007 Annual Report Wisconsin Birth Defects Registry Maternal and Child Health Program Family Health Section Bureau of Community Health Promotion Division of Public Health Wisconsin Department of Health

More information

Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program

Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program WHAT S KNOWN ON THIS SUBJECT: Prenatal diagnosis and clinical examination do not identify all infants with critical

More information

Submitting Data to ISCA and NCBI

Submitting Data to ISCA and NCBI Submitting Data to ISCA and NCBI created by Tim Hefferon last updated August 28, 2012 Dear ISCA Submitter, This brief guide is intended to make the submission of your copy number variation and clinical

More information

Maternal and Child Health Indicators: Three State Profile

Maternal and Child Health Indicators: Three State Profile Indicators: Three State Profile Elizabeth Oftedahl MPH Symposium Pyle Center, August 11, 2006 Preceptor: Kristin Hill, MSHA Mentor: Alexandra Adams, MD, PhD Great Lakes Inter-Tribal Council / Great Lakes

More information

Mississippi State Department of Health. Fiscal Years 2010-2014. Strategic Plan

Mississippi State Department of Health. Fiscal Years 2010-2014. Strategic Plan Mississippi State Department of Health Fiscal Years 2010-2014 Strategic Plan Prepared in Accordance with the Mississippi Performance Budget and Strategic Planning Act of 1994 Office of Health Administration

More information