1. Preterm Birth, Infant Mortality and Birth Defects National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities Division of Birth Defects and Developmental Disabilities

2. Preterm Birth and Birth Defects  Overlapping outcomes  Top 2 leading causes of infant mortality  Birth defects are associated with increased risk of preterm birth (infants w/ BD = 2.7 times more likely to be born preterm; 11.5 times more likely to be born very preterm)  Babies born preterm have a 2-3 fold higher likelihood of having a birth defect  Shared risk factors  Family history  Assisted reproductive technology (ART)  Maternal medical conditions, such as diabetes, obesity  Maternal infectious diseases, such as varicella  Behavioral factors, such as alcohol and cigarette smoking

3. Preterm Births and Infant Mortality among Infants with and without Birth Defects  National Birth Defects Prevention Study multi-state, population-based case-control study  Preterm birth and small-for-gestational age among infants with birth defects  Some examples of research focused on preterm birth among controls (infants without birth defects) Maternal infections during pregnancy Maternal medication use, such as SSRI Periconceptional intake of folic acid and food folate Maternal dietary nutrient intake

4. Opportunities for Reducing Infant Mortality due to Birth Defects: Treatment and Prevention  Appropriate and timely treatment  Addressing disparities in care and survival  Prevention through preconception health  Ensuring sufficient folic acid intake before and during early pregnancy  Screening and brief intervention to decrease alcohol-exposed pregnancies  Eliminating smoking during pregnancy  Reducing pre-pregnancy obesity  Keeping diabetes well-controlled before and during pregnancy  Planning for safe medication use in pregnancy

5. Inclusion of Birth Defects in Plans to Reduce Infant Mortality  Partner with birth defects surveillance program and other key state programs  Partner with parent support groups and advocacy groups working on preventing birth defects and improving the lives of those with birth defects  Engage in preconception health to impact risk of birth defects and preterm birth