(Write down what is causing the NTDs in this area. Give evidence to support your response.) "Investigation" Sheet Causes of Birth Defects: An Epidemiological Mystery Trish Strohfeldt, CDC’s 2005 Science Ambassador Program Team Assignment: (doctor, parent, etcRequest for Investigation Notes on the Case (Write down any important facts from the "Request for Investigation".) Researching with other Team Members Notes on the Case (Write down important information you find as you research your assigned file and Web resources.) Patient File 1: Gabriella Perez (Not Real Data) Causes of Birth Defects: An Epidemiological Mystery Trish Strohfeldt, CDC’s 2005 Science Ambassador Program Midtown Medical Center 12290 W. Townhall Road Patient File Date: 7/27/05 Name: Gabriella Perez Address: 3290 N. 5th Street Date of Birth (DOB): 5/22/05 Sex: female Age: 2 months Race: Hispanic -Patient History: Gabriella Perez is a 2-month-old baby girl with big brown eyes and a few tufts of brown hair. She is very calm when you examine her and even gives you a smile. Gabriella was born with spina bifida. Her mother reports that she started taking a prenatal vitamin as soon as she found out she was pregnant, but she did not realize that she was pregnant until her 3rd month of pregnancy. Gabriella’s mother also reports that she was diagnosed with type II diabetes about two years ago. Two prior siblings were born with no neural tube defect, and there was no other family history of NTDs. Both parents are overweight and are smokers. Gabriella’s mother tells you that she is overwhelmed by her daughter’s health care needs, and wants you to tell her why Gabriella has spina bifida. STATE BIRTH DEFECTS SURVEILLANCE PROGRAM DIRECTORY S130 Birth Defects Research 111: S1-S180 (2019) California California Birth Defects Monitoring Program (CBDMP) Purpose: Surveillance, Research Partner: Local Health Departments, Hospitals, Universities Program status: Currently collecting data Start year: 1983 Earliest year of available data: 1983 Organizational location: Department of Health (Genetic Disease Screening Program/ Center for Family Health/ California Department of Public Health) Population covered annually: 70,000 Statewide: No, CBDMP currently monitors a ten-county subset of California births that are demographically similar to the state as a whole and whose birth defects rates and trends have been reflective of those throughout California. Furthermore, CBDMP has statutory authority to conduct active surveillance anywhere in the state when warranted by environmental incidents or concerns. Current legislation or rule: California Health and Safety Code, Division 102, Part 2, Chapter 1, Sections 103825-103855, effective 1982, recodified 1996 Legislation year enacted: 1982 Case Definition Pregnancy outcome: Livebirths (All gestational ages and birth weights), Fetal deaths - stillbirths, spontaneous abortions, etc. (All gestational ages), Elective terminations (All gestational ages) Age: One year Residence: In-state births to residents of counties monitored by CBDMP Surveillance Methods Case ascertainment: Active Case Finding Delivery hospitals: Disease index or discharge index, Discharge summaries, Obstetrics logs (i.e., labor & delivery), Regular nursery logs, ICU/NICU logs or charts, Pediatric logs, Postmortem/pathology logs, Surgery logs, Cardiac catheterization laboratories, Specialty outpatient clinics Pediatric & tertiary care hospitals: Disease index or discharge index, Discharge summaries, ICU/NICU logs or charts, Pediatric logs, Postmortem/pathology logs, Surgery logs, Laboratory logs, Cardiac catheterization laboratories Other specialty facilities: Cytogenetic laboratories, Genetic counseling/clinical genetic facilities Case Ascertainment Conditions warranting chart review in newborn period: Any chart with an ICD-9-CM code 740-759/ICD-10-CM code Q00-Q99, Any chart with a selected list of ICD-9-CM codes outside 740-759/ICD-10-CM codes outside Q00-Q99, Any chart with selected procedure codes, Any chart with selected defects or medical conditions (i.e. abnormal facies, congenital heart disease), All stillborn infants, All elective abortions, All neonatal deaths, All prenatally diagnosed or suspected cases Conditions warranting chart review beyond the newborn period: Facial dysmorphism or abnormal facies, Failure to thrive, CNS condition (e.g. seizure), GI condition (e.g. intestinal blockage), GU condition (e.g. recurrent infections), Cardiovascular condition, All infant deaths (excluding prematurity), Ocular conditions, Any infant with a codable defect Coding: CDC-modified BPA codes, further modified for use in California Data Collected Infant/fetus: Identification information (name, address, date-of-birth, etc.), Demographic information (race/ethnicity, sex, etc.), Birth measurements (weight, gestation, Apgars, etc.), Tests and procedures, Infant complications, Birth defect diagnostic information Mother: Identification information (name, address, date-of-birth, etc.), Demographic information (race/ethnicity, sex, etc.), Gravidity/parity, Illnesses/conditions Father: Identification information (name, address, date-of-birth, etc.), Demographic information (race/ethnicity, sex, etc.), Family history Data Collection Methods and Storage Data collection: Electronic file/report filled out by staff at facility