Birth Defects Surveillance Guidelines

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Birth Defects Surveillance Guidelines
National Standards for Birth Defects Surveillance
 Guidelines for Conducting Birth Defects Surveillance
National Birth Defects Prevention Network

The technical guidelines in this document consist of a series of chapters covering the fundamental aspects of developing, planning, implementing, and conducting surveillance for birth defects and using the resulting data. They provide a way of improving the quality of birth defects surveillance data, which in turn enhances their use.

The Guidelines will be updated and revised over time. Whenever a revision is published, a revision date will appear in the chapter header to distinguish that page or pages from previous versions.

Comments and suggestions on this document are welcome. Submit comments to the Surveillance Guidelines and Standards Committee via e-mail at

Click here for revised descriptions of birth defects and data elements

Title, Reference and Acknowledgement

Table of Contents


Chapter 1 The Whys and Hows of Birth Defects Surveillance – Using Data

Chapter 2 Legislation
Appendix 2.1 Sample State Legislation
Appendix 2.2 Table of Birth Defects Legislation
Appendix 2.3 Definitions Used to Determine Covered Entity Status Under the Privacy Rule
Appendix 2.4 Office of Civil Rights (OCR) HIPAA Privacy Regulation Text
Chapter 3 Case Definition
Appendix 3.1 Birth Defects Descriptions for NBDPN Core, Recommended, and Extended Conditions (this replaces old appendices 3.1 & 3.2) - Updated 3/2021
Appendix 3.3 Examples of Conditions Considered to Be Minor Anomalies
Appendix 3.4 Conditions Related to Prematurity in Infants Born at Less Than 36 Weeks Gestation
Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects
Chapter 4 Data Variables (also called Data Elements)
Appendix 4.1 Descriptions of NBDPN Data Elements for Population-based Birth Defects Surveillance (this replaces old appendices 4.1 & 4.2) - Updated 3/2015
Chapter 5 Classification and Coding
Appendix 5.1 Texas Disease Index
Appendix 5.2 6-Digit CDC Codes - Updated 8/2007
Chapter 6 Case Ascertainment Methods
Appendix 6.1 Data Source Described in Detail – Vital Records
Appendix 6.2 Data Source Described in Detail – Hospital Data Sets
Appendix 6.3 Data Source Described in Detail – Hospital and Patient Services Logs
Appendix 6.4 Data Source Described in Detail – Genetic Services
Chapter 7 Data Quality Management
Appendix 7.1 Data Sources Descriptive Assessment Tool
Chapter 8 Statistical Methods

Chapter 9 Data Management and Security

Chapter 10 Data Collaboration and Dissemination through the NBDPN

Chapter 11 Data Presentation
Appendix 11.1 Data Suppression
Appendix 11.2 Use of Geographic Information Systems (GIS) to Map Data
Appendix 11.3 Data Users Matrix
Appendix 11.4 What Type of Chart or Graph Should I Use?
 Chapter 12 Inclusion of Prenatal Diagnoses in Birth Defects Surveillance
Appendix 12.1 Components for Incorporating Prenatal Diagnosis into Birth Defects Surveillance
Appendix 12.2 Suggested List of Prenatal Diagnoses That Can Be Included in Prevalence Estimates Without a Clinician’s Review of the Defect Certainty
Appendix 12.3 Suggested List of Data Variables to Collect for Prenatally Diagnosed Defects

Complete Manual (9MB)
National Standards for Birth Defects Surveillance

The National Birth Defects Prevention Network (NBDPN) has developed standards for population-based birth defects surveillance in the United States. These standards are a priority for NBDPN in order to improve the quality and consistency of birth defects data, and to facilitate data use that benefits public health.
National standards on data quality and data utility for birth defects surveillance can be found below: 
  1. Background on the development and implementation of data quality standards for population-based birth defects surveillance
  2. Data Quality Assessment Tool
  3. Data Utilization Assessment Tool
Overall summary results from the population-based birth defects program self-assessment are located below:
  1. 2022 Birth Defects Surveillance Systems: NBDPN Data Quality Assessment Report Summary
  2. 2019 Birth Defects Surveillance Systems: NBDPN Data Quality Assessment Report Summary
The NBDPN will continue to conduct ongoing assessment of data quality performance measures and national standards on data utility and welcome your input. Comments and questions can be sent to