Birth Defects Clusters

Link to a list of Texas birth defect cluster investigations.

From the Environmental and Injury Epidemiology and Toxicology Branch regarding Midlothian, Texas and nearby cement plants.

Adapted with permission from the National Birth Defects Prevention Network.

External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services. These sites may also not be accessible to people with disabilities.

Background

What is a birth defect?

• A birth defect is an abnormality that is present at birth, such as a missing limb, malformed heart, or Down syndrome.
  
• Birth defects occur in about 3% of births--more than 122,000 babies in the US every year. Women of all ages, races/ethnicities, education, and income levels are at risk for having a baby with a birth defect.
  
• The causes of most birth defects are unknown, but through research and surveillance causes may be identified and prevention measures developed.

What is a birth defects cluster?

• When too many babies are born with the same birth defect for a defined period and geographical area, this is called a cluster.

What causes clusters?

• Birth defects, like all other health conditions, often occur in clusters.
  
• Most happen by coincidence or chance alone
  
• Others can be explained by changes in diagnostic practices or hospital referral patterns
  
• Rarely, a cluster is due to an environmental exposure that all the mothers or fathers have in common.

Why investigate birth defects clusters?

• The purpose of evaluating cluster reports is to determine if an increase in birth defects has occurred and, if so, whether there is an exposure that may be linked.
  
• A cluster investigation cannot answer parents' questions about why their child was born with a birth defect. Causes can only be identified through large case-control interview studies, like the National Birth Defects Prevention Study.

What characterizes a cluster caused by an environmental exposure?

Evidence includes:

• A large increase in babies born with the same birth defect and
  
• A prenatal exposure that the mothers or fathers have in common, such as illness, diet, medication, alcohol or drugs, or chemicals at home or work.

About the Investigation

Who should I report a cluster to?

• Suspected clusters should be reported to the public health officer in your county health department or the state department of health.

What information should I include in a cluster report?

• In order to evaluate the report, investigators need to know:
  
  • For each child, the names of the mother and baby, date and hospital of birth, and all the child's diagnoses
    
  • Ideas about environmental exposures during early pregnancy. To determine if the cases may have the same cause, investigators need to know what exposures all the mothers have in common.

What about the confidentiality of the information I provide?

• State law requires that all identifying information be kept confidential.
  
• Only investigating staff have access to this information
  
• Public reports are limited to summary data.

What will happen after I make a report?

• Investigators will determine
  
  • If all the babies have the same birth defect
    
  • Whether there are more babies with the same birth defect than would normally be expected in a given area for a given time period (many conditions are more common than people realize).
    
  • If there is a common exposure that may explain the increase.
    
  • Parents may be asked to provide more information and to give permission for investigators to review their medical records.
    
  • A written report will be made of the investigation's findings.
    

For more information about cluster investigations in Texas, contact:

Birth Defects Epidemiology & Surveillance
Texas Department of State Health Services
1100 W. 49th Street
Austin TX 78756
512-458-7232

TDH Pub. No. E58-11581

Birth Defects Epidemiology and Surveillance Home Page

Last Updated July 10, 2007.