The purpose of this project is to identify modifiable maternal exposures in early pregnancy that may increase the risk for having a pregnancy affected by certain major, structural birth defects. Grantees will use data from existing birth defects surveillance systems to identify children with the 17 birth defects categories. Mothers of these case infants and mothers of randomly selected live born control infants will be contacted and invited to participate in a maternal interview. The interview will focus on the key areas of: () diabetes, obesity, and physical activity;(2) other chronic maternal medical conditions;(3) infertility;and (4) medication use;in addition to other exposures with promising prevention potential such as genitourinary infections, fever, and maternal occupation. Kits will be mailed to participating families to collect saliva samples and provisions will be made for the collection of residual newborn bloodspots, enhancing the potential for gene-environment interaction studies.
Nationwide, congenital malformations are the leading cause of death among infants in the first year of life, about 4% of all live born infants have a major birth defect. Not all children die, many who live have resulting morbidity and disability, high health care costs and families may face large burdens both personal and financial. Over 60% of birth defects are of unknown origin, recent developments, such as folic acid, hold out the promise of preventing birth defects. The BD-Steps will focus on modifiable factors in an effort to prevent the occurrence of birth defects.