Birth Defects Surveillance System, 1990-1999
West Virginia Residents

The West Virginia Birth Defects Surveillance System (BDSS) was established in 1989 to monitor the occurrence of birth defects among the state's children. The BDSS is housed within the West Virginia Bureau for Public Health and is administered jointly by the Office of Maternal, Child and Family Health and the Office of Epidemiology and Health Promotion.

Using data from the BDSS registry, 5,161 state residents born from 1990 through 1999 were diagnosed with one or more birth defects. Based upon the 214,497 births that occurred to West Virginia residents during that same time period, a rate of 24.1 defects per 1,000 live births results. However, when compared to national figures, the rate is low. In order to produce a more accurate report of the prevalence of birth defects, an effort was made to detect cases of birth defects from other sources. Since the presence of congenital anomalies is noted on the birth certificate, all birth certificate records that indicated a congenital anomaly not already in the BDSS were added to the data set. In addition, any fetal death* record that indicated a congenital anomaly was the underlying cause of death was also added. With these additions, 8,096 West Virginia residents were observed to have one or more birth defects, a rate of 37.7 per 1,000 live births.

* Death of a fetus with a gestational age of at least 20 weeks.

Demographic Factors

A demographic factor that influences the rate of birth defects is maternal age. Women 35 years and older have higher rates of children with birth defects than those of younger ages, 42.2 defects per 1,000 live births, as compared to 37.7 for women of all ages.

The weight of infants at the time of birth is an important factor affecting the rate of birth defects. In infants that weighed less than 1,500 grams (three pounds, five ounces) a rate of 211.6 per 1,000 live births was observed. Babies between 1,500 and 2,499 grams (five pounds, eight ounces) had defects at a rate of 81.2. Of infants who weighed 2,500 grams or more, only 31.8 per 1,000 live births had defects.

There is a marked difference in the rates of birth defects between premature births and infants who are born after a normal gestational period. Children with a gestational age of less than 37 weeks were diagnosed with one or more congenital anomalies at a rate of 92.1 per 1,000 live births. However, those with a gestational age of 37 weeks or more were diagnosed at a rate of 31.9 per 1,000 live births.

There is a measurable difference between the observed rates of birth defects among white mothers and mothers of other races. Children of mothers of other races had a reported rate of birth defects of 48.1 per 1,000 live births, while children of white mothers were observed to have birth defects at a rate of 37.3 per 1,000 live births.

Multiple births is another factor that tends to increase the rate of birth defects. Singleton births produce a rate of 36.8 birth defects per 1,000 live births. In contrast, twins, triplets, and quadruplets collectively have birth defects at a rate of 63.4, nearly twice that of singleton births.

The timeliness of prenatal care affects the rate of birth defects. Those women who received no prenatal care produced children with defects at a rate of 58.3 per 1,000 live births. In contrast, those who began prenatal care in the first trimester of pregnancy gave birth to children with defects at a rate of 36.7 and those who started prenatal care during the second trimester produced children with defects at a rate of 36.2. Those who waited until the third trimester had a birth defect rate of 41.0.

As with timeliness, the quantity of prenatal care affects the rate of birth defects. Those women who visited their obstetricians fewer than 10 times before giving birth produced children with defects at a rate of 41.7 per 1,000 live births. Those who had 10 to 19 prenatal visits gave birth to children with defects at a rate of 34.7. However, those who had 20 or more prenatal visits, most likely those known to have pregnancy complications, produced children with defects at a much higher rate, 53.6 per 1,000 live births.

The prevalence of birth defects declines as the education level of mothers increases. Mothers with less than 12 years of education gave birth to children with defects at a rate of 39.3 per 1,000 live births. Those with 12 years of education produced children with defects at a rate of 37.2. Mothers who had 13 or more years of education gave birth to children with defects at an even smaller rate, 34.1 per 1,000 live births.

Women who consume alcohol greatly increase the risk of giving birth to children with defects. Children of women who did not consume alcohol had a reported rate of 37.2 birth defects per 1,000 live births. However, women who drank alcoholic beverages during pregnancy gave birth to children with birth defects at an observed rate of 71.6.

Children of mothers who smoked during pregnancy have a higher risk of birth defects than those whose mothers did not smoke. Mothers who smoked gave birth to children with birth defects at a rate of 41.6 per 1,000 live births, as compared to a rate of 36.4 among children of mothers who did not smoke during pregnancy.

The rate of birth defects by county of residence varies widely (see Table Two). Fayette County had the highest observed rate, 62.0 per 1,000 live births, followed by Raleigh County (56.2) and Berkeley County (54.3). The lowest observed rates were in Mercer County (20.9), Logan County (23.5), and Kanawha County (24.6).

Table Two Birth Defects by County of Residence West Virginia Residents, 1990 - 1999
County of Residence	Births With Defects	Rate per 1,000 Live Births	County Rank	County of Residence	Births With Defects	Rate per 1,000 Live Births	County Rank
Barbour	86	48.1	7	Monongalia	414	47.4	10
Berkeley	500	54.3	3	Monroe	38	27.5	48
Boone	100	30.7	39	Morgan	66	45.1	14
Braxton	60	38.7	25	Nicholas	103	34.5	34
Brooke	101	38.3	26	Ohio	286	50.4	5
Cabell	457	38.7	24	Pendleton	30	33.2	36
Calhoun	35	42.7	18	Pleasants	26	29.9	43
Clay	38	28.8	45	Pocahontas	33	32.9	37
Doddridge	33	40.2	21	Preston	154	45.5	12
Fayette	358	62.0	1	Putnam	161	28.1	47
Gilmer	33	44.9	15	Raleigh	495	56.2	2
Grant	59	42.9	17	Randolph	153	46.6	11
Greenbrier	145	36.8	31	Ritchie	39	35.5	33
Hampshire	88	38.1	28	Roane	48	28.4	46
Hancock	95	27.3	50	Summers	53	43.3	16
Hardy	45	31.4	38	Taylor	88	53.3	4
Harrison	328	38.1	27	Tucker	40	49.5	6
Jackson	81	25.9	52	Tyler	31	30.0	41
Jefferson	208	40.9	20	Upshur	108	40.2	22
Kanawha	622	24.6	53	Wayne	202	39.8	23
Lewis	75	37.7	30	Webster	31	27.3	49
Lincoln	77	27.2	51	Wetzel	94	41.1	19
Logan	118	23.5	54	Wirt	19	29.9	44
McDowell	118	30.0	42	Wood	396	36.8	32
Marion	245	37.9	29	Wyoming	147	47.9	8
Marshall	190	47.6	9
Mason	97	33.3	35
Mercer	167	20.9	55	WV Total	8,096	37.7
Mineral	143	45.3	13
Mingo	135	30.3	40
County of Residence	Births With Defects	Rate per 1,000 Live Births	County Rank	County of Residence	Births With Defects	Rate per 1,000 Live Births	County Rank

As with data by county, a wide variance is observed in the reporting of birth defects by hospital of birth (see Table Three). Of hospitals where at least 100 births occurred during the time period of 1990 - 99, the highest observed rates of birth defects were recorded at West Virginia University Hospital, with a rate 92.5 birth defects per 1,000 live births, City Hospital (63.8), and Calhoun General Hospital (63.0). The lowest rates were reported at New River Birthing Center (4.5), Putnam General Hospital (10.0), and Putnam Birthplace (11.8). The difference in rates by hospital may be more a measurement of completeness of reporting than the health of the babies delivered in the various facilities. In addition, birthing centers and smaller hospitals refer high-risk pregnancies to the state's three tertiary care hospitals, i.e., WVU Hospital, CAMC, and Cabell-Huntington Hospital, a possible factor in WVU Hospital's high rate. Other issues such as the quality of prenatal care available at the surveyed facilities may also be factors in rate variation.

 

Table Three Birth Defects by Hospital1 of Birth by Source of Report West Virginia Residents, 1990-1999
Hospital of Birth	Birth Defects Registry		Vital Statistics2		Combined Birth Defects
	Number	Rate	Number	Rate	Number	Rate	Rank
Bluefield Regional Medical Center	89	17.6	28	5.5	117	23.1	30
CAMC - Women & Children's	729	19.9	160	4.4	889	24.3	29
Cabell-Huntington Hospital	586	35.7	93	5.7	679	41.3	8
Calhoun General Hospital	13	54.6	2	8.4	15	63.0	3
Camden-Clark Memorial Hospital	167	22.9	49	6.7	216	29.6	22
City Hospital	410	50.5	108	13.3	518	63.8	2
Davis Memorial Hospital	188	34.9	32	5.9	220	40.9	9
Fairmont General Hospital	136	21.9	23	3.7	159	25.7	26
Grant Memorial Hospital	65	20.7	38	12.1	103	32.8	15
Greenbrier Valley Hospital	89	18.5	72	14.9	161	33.4	13
Jackson General Hospital	11	9.4	12	10.3	23	19.7	33
Jefferson Memorial Hospital	20	10.0	46	23.0	66	33.0	14
Logan General Hospital	70	11.6	51	8.5	121	20.1	32
Monongalia General Hospital	91	20.8	17	3.9	108	24.7	27
New River Birthing Center	0	0.0	1	4.5	1	4.5	37
Ohio Valley Medical Center	63	24.7	31	12.2	94	36.8	10
Pleasant Valley Hospital	25	22.3	14	12.5	39	34.7	11
Preston Memorial Hospital	40	22.7	17	9.6	57	32.3	16
Princeton Community Hospital	27	5.1	62	11.7	89	16.8	34
Putnam Birthplace	2	7.9	1	3.9	3	11.8	35
Putnam General Hospital	1	10.0	0	0.0	1	10.0	36
Raleigh General Hospital	146	8.8	885	53.1	1,031	61.8	4
Reynolds Memorial Hospital	41	21.2	13	6.7	54	27.9	24
Roane General Hospital	13	8.9	23	15.8	36	24.7	28
St. Joseph's Hospital (Wood)	190	39.3	21	4.3	211	43.6	7
St. Joseph's Hospital (Upshur)	56	21.5	26	10.0	82	31.4	18
St. Mary's Hospital	37	9.0	53	12.8	90	21.8	31
Stonewall Jackson Memorial Hospital	67	26.4	14	5.5	81	31.9	17
Summersville Memorial Hospital	31	12.1	36	14.1	67	26.2	25
Thomas Memorial Hospital	162	36.3	35	7.9	197	44.2	6
United Hospital Center - Downtown	171	18.0	127	13.4	298	31.4	19
Weirton Medical Center	52	20.8	24	9.6	76	30.4	21
Welch Emergency Hospital	26	13.4	31	16.0	57	29.4	23
West Virginia University Hospital	728	69.6	240	22.9	968	92.5	1
Wetzel County Hospital	32	19.6	18	11.0	50	30.6	20
Wheeling Hospital	339	47.6	18	2.5	357	50.1	5
Williamson Memorial Hospital	23	16.1	26	18.2	49	34.3	12
West Virginia Total	5,161	24.1	2,935	13.7	8,096	37.7
Hospital of Birth	Number	Rate	Number	Rate	Number	Rate	Rank
	Birth Defects Registry		Vital Statistics2		Combined Birth Defects
1. Only hospitals with at least 100 births from 1990 through 1999 are included. 2. Birth records indicating a congenital anomaly not in the birth defects registry.

This brief is intended only to provide statistical data on the numbers and rates of reported birth defect incidences from 1990-99 and does not include services available for children who have been affected. For more information on services available, please contact the Office of Maternal, Child and Family Health at 1-800-642-8522.