Birth defects (also called congenital malformations) are conditions that happen when a baby does not develop normally during pregnancy. Structural defects may include missing limbs, malformed hearts, spina bifida and genetic conditions like Down Syndrome. Most birth defects happen during the first three months of pregnancy and are detected within the first year of life. Some birth defects (such as cleft lip or clubfoot) are easy to see, but others (such as heart defects or hearing loss) are found using special tests (such as x-rays, CT scans, or hearing tests). Birth defects can vary from mild to severe.

This site provides data on NYC children born with one or more of 12 major birth defects. Each of the 12 birth defects is defined in the glossary on this site. The data comes from the NYS Department of Health Congenital Malformations Registry.

Birth Defects and the Environment

Scientists believe most birth defects are caused by a complex mix of factors including our genes, behaviors and environment. However, the causes of most birth defects are unknown. The fetus is more sensitive to exposures than an adult and if exposures happen during important periods of development, birth defects may result. Although there has been some research into how environmental exposures might cause birth defects, there is still much more work that needs to be done to understand the relationship of these exposures to birth defects.

Known and probable risk factors for birth defects include the following: smoking, use of alcohol and other drugs, poor nutrition and/or health (such as low levels of folic acid, obesity and poorly controlled diabetes), some medicines (prescription & over-the-counter), toxic chemicals (such as lead, paint and paint thinner, gasoline, pesticides, and secondhand smoke), infectious agents (such as rubella and toxoplasmosis) and ionizing radiation (x-rays).

About the Data and Indicators

Collecting and sharing good data about the occurrence of birth defects is a first step in understanding how they might be related to the environment. Looking at patterns of birth defect rates can help health officials plan services and create ideas for research into environmental causes of birth defects.

All birth defects in any child less than two years old are reportable under New York State law to the State Congenital Malformations Registry.

Most birth defect reports are abstracted from inpatient hospital records, since birth defects diagnosed on an outpatient basis are not well reported.

Accurate hospital clinical recognition of birth defects depends on clinical expertise and interest. This is particularly true of conditions more difficult to diagnose. As a result, identification of birth defects may vary by area and by time. Areas with hospitals that provide higher levels of care may have more thorough diagnoses and, thus, apparently higher rates. Similarly, areas with hospitals that report cases more completely will also appear to have higher rates.

Prevention

Not all birth defects can be prevented, but actions that increase the chance of having a healthy baby include:

• Have regular medical checkups and check with a provider before taking any medications.
• Eat healthy foods and maintain a healthy weight; avoid alcohol and don’t use street drugs.
• Make sure that medical conditions like diabetes are under control.
• Take a vitamin with folic acid before and during pregnancy.
• Quit smoking and avoid exposure to secondhand smoke.
• Damaged lead-containing paint in homes should be safely addressed by properly trained workers, ideally prior to pregnancy.  Pregnant women and small children should stay out of the home until lead paint projects are completed.
• Employers should provide workplaces free from unsafe chemical exposures and provide protective gear to workers when necessary. To learn more about the chemicals at work, employees can ask their employer for the Material Safety Data Sheets for the products used.

Key Messages

About one out of every 33 babies is born with a birth defect. A birth defect can affect almost any part of the body. The well being of the child who is born with a birth defect depends mostly on which organ or body part is involved, how much it is affected and the quality of rehabilitative support received in early childhood.

Heart defects make up about one-third to one-fourth of all birth defects, affecting about one in every 100 to 200 births. Some of these heart defects can be serious, and a few are very severe.

Other common birth defects are “neural tube defects,” which are defects of the spine (spina bifida) and brain (anencephaly). They affect about one of every 1,000 pregnancies. These defects can be serious and are often life threatening.

Birth defects of the lip and roof of the mouth, known as “orofacial clefts,” include cleft lip, cleft palate, and combined cleft lip and cleft palate. These defects are also common and occur in about one in 700 to 1,000 babies.

There are many schemes of neighborhood boundaries (or geographies) available for different datasets. These include:

• Citywide
• Borough
• United Hospital Fund 42 (UHF42) and United Hospital Fund 34 (UHF34) neighborhoods
• Community Districts (CD), and, related, Community District Tabulation Areas (CDTA)
• Public Use Microdata Areas (PUMA)
• Neighborhood Tabulation Areas (NTA)

We try to make data available at as fine a geographic resolution as we can. Read more about different geographies at this data story.

It would be convenient if each dataset could be made available at the same geography, but this is not always possible. The neighborhood boundaries available depend on the specifics of the underlying dataset.

When we have multiple years of data, we show the data as trend charts.

Trends for individual neighborhoods tend to be very unstable (or "bouncy"), due to small counts for outcomes in individual neighborhoods. To show clearer trends, we usually aggregate up and show trend data by Borough.

Options on some indicators let you compare this indicator to other similar indicators.

We try to make data available as soon as we can.

Many datasets take a long time to reach us — a "lag" of several years, during which data are gathered from different entities to try to create a complete dataset; data are processed (cleaned, deduplicated, etc), and analyzed. It can take several years to prepare a dataset — so a dataset that is several years old is sometimes the most up-to-date information available. Still, this data continues to show us valuable trends and insights.

We also try to display datasets that have been available for many years. Some datasets (like those that are asked on surveys) are not asked every year of the survey, which means that we cannot provide annual data.

For some datasets, we have to aggregate time periods in order to break down data by borough or neighborhood.

Measures are the numeric ways that a dataset (or indicator) are expressed. Examples of different measures might be: number, percent or rate.

A number tells us how much of an outcome is in a certain area. But a rate (usually expressed as, for example, 40 per 100,000) tells us how much of an outcome there is, relative to the population of the area in question. This lets us compare neighborhoods of different sizes.

On this site, we try to show how environmental factors might be connected to health outcomes. One way we do this is with Correlates. We choose potentially-related datasets and display them on a scatterplot so you can see how these two datasets are correlated.

The Disparities view displays neighborhoods by poverty category to show underlying disparities in the data.

Read more about correlation here.