California Birth Defects Monitoring

California Birth Defects Monitoring Program (CBDMP) Birth Defects Report Summary

Table 1: Overall Prevalence of Selected Birth Defects: 2018–2020

Birth Defect	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Anopthalmia/Micropthalmia	37	1.0	0.7–1.3
Anotia/Microtia	130	3.3	2.8–4.0
Cleft Lip and/or Cleft Palate	607	15.6	14.4–16.9
Congenital Heart Defects	2905	74.7	72.0–77.5
Craniosynostosis	193	5.0	4.3–5.7
Esophageal Atresia/Tracheoesophageal Fistula	79	2.0	1.6–2.5
Gastroschisis	136	3.5	2.9–4.1
Hypospadias**	901	45.2	42.3–48.3
Limb Deficiencies	127	3.3	2.7–3.9
Neural Tube Defects	281	7.2	6.4–8.1
Omphalocele	79	2.0	1.6–2.5
Trisomy 13	44	1.1	0.8–1.5
Trisomy 18	103	2.6	2.2–3.2
Trisomy 21	683	17.6	16.3–18.9

*Three year case count per 10,000 live births

**Hypospadias includes male or unknown gender in the numerator and male live births in the denominator

Data Source: California Birth Defects Monitoring Program Registry, 2018–2020, California 10-County Catchment Area (Fresno, Kern, Kings, Madera, Merced, Orange, San Diego, San Joaquin, Stanislaus, and Tulare)

Table 2: Prevalence of Selected Birth Defects by Mother’s Age: 2018–2020

Anopthalmia/Micropthalmia

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	6	0.8	0.3–1.6
25–29	9	0.8	0.4–1.6
30–34	11	0.9	0.5–1.7
35–39	10	1.5	0.7–2.7
40 and over	1	0.6	0.0–3.2

Anotia/Microtia

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	26	3.3	2.1–4.8
25–29	31	2.9	2.0–4.1
30–34	41	3.5	2.5–4.8
35–39	26	3.8	2.5–5.6
40 and over	6	3.4	1.3–7.4

Cleft Lip and/or Cleft Palate

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	115	14.4	11.9–17.3
25–29	150	14.1	12.0–16.6
30–34	186	15.9	13.7–18.4
35–39	120	17.6	14.6–21.0
40 and over	34	19.4	13.4–27.1

Congenital Heart Defects

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	585	73.2	67.4–79.4
25–29	743	69.9	65.0–75.1
30–34	739	63.3	58.8–68.0
35–39	596	87.3	80.4–94.5
40 and over	237	135.0	118.5–153.2

Craniosynostosis

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	23	2.9	1.8–4.3
25–29	64	6.0	4.6–7.7
30–34	63	5.4	4.1–6.9
35–39	33	4.8	3.3–6.8
40 and over	10	5.7	2.7–10.5

Esophageal Atresia/Tracheoesophageal Fistula

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	16	2.0	1.1–3.3
25–29	18	1.7	1.0–2.7
30–34	22	1.9	1.2–2.9
35–39	15	2.2	1.2–3.6
40 and over	8	4.6	2.0–9.0

Gastroschisis

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	70	8.8	6.8–11.1
25–29	40	3.8	2.7–5.1
30–34	23	2.0	1.2–3.0
35–39	2	0.3	0.0–1.1
40 and over	1	0.6	0.0–3.2

Hypospadias**

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	158	38.6	32.8–45.1
25–29	226	41.6	36.4–47.4
30–34	271	45.3	40.1–51.0
35–39	197	56.3	48.8–64.8
40 and over	49	54.4	40.3–71.9

Limb Deficiencies

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	34	4.3	2.9–5.9
25–29	31	2.9	2.0–4.1
30–34	32	2.7	1.9–3.9
35–39	26	3.8	2.5–5.6
40 and over	4	2.3	0.6–5.8

Neural Tube Defects

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	82	10.3	8.2–12.7
25–29	77	7.2	5.7–9.1
30–34	70	6.0	4.7–7.6
35–39	41	6.0	4.3–8.1
40 and over	11	6.3	3.1–11.2

Omphalocele

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	15	1.9	1.1–3.1
25–29	18	1.7	1.0–2.7
30–34	17	1.5	0.8–2.3
35–39	19	2.8	1.7–4.3
40 and over	10	5.7	2.7–10.5

Trisomy 13

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	3	0.4	0.1–1.1
25–29	3	0.3	0.1–0.8
30–34	16	1.4	0.8–2.2
35–39	17	2.5	1.5–4.0
40 and over	4	2.3	0.6–5.8

Trisomy 18

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	9	1.1	0.5–2.1
25–29	12	1.1	0.6–2.0
30–34	16	1.4	0.8–2.2
35–39	40	5.9	4.2–8.0
40 and over	26	14.8	9.7–21.7

Trisomy 21

Mother’s Age (Years)	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
24 and under	61	7.6	5.8–9.8
25–29	66	6.2	4.8–7.9
30–34	136	11.6	9.8–13.8
35–39	227	33.2	29.1–37.9
40 and over	193	109.9	95.0–126.5

*Three year case count per 10,000 live births

**Hypospadias includes male or unknown gender in the numerator and male live births in the denominator

Table 3: Prevalence of Selected Birth Defects by Mother's Race and Ethnicity: 2018–2020

Anopthalmia/Micropthalmia

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	1	0.2	0–1.1
Black/Non-Hispanic	1	0.7	0–3.9
Hispanic	27	1.4	0.9–2.1
White/Non-Hispanic	4	0.4	0.1–0.9

Anotia/Microtia

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	18	3.5	2.0–5.5
Black/Non-Hispanic	2	1.4	0.2–5.1
Hispanic	80	4.2	3.4–5.3
White/Non-Hispanic	22	2.0	1.3–3.0

Cleft Lip and/or Cleft Palate

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	4	10.3	2.8–26.3
Asian/Non-Hispanic	72	13.8	10.8–17.4
Black/Non-Hispanic	12	8.4	4.3–14.7
Hispanic	300	15.9	14.2–17.8
White/Non-Hispanic	157	14.3	12.1–16.7

Congenital Heart Defects

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	30	77.0	52.0–109.7
Asian/Non-Hispanic	255	49.0	43.2–55.4
Black/Non-Hispanic	102	71.3	58.2–86.5
Hispanic	1518	80.6	76.6–84.8
White/Non-Hispanic	765	69.4	64.6–74.5

Craniosynostosis

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	1	2.6	0.1–14.3
Asian/Non-Hispanic	11	2.1	1.1–3.8
Black/Non-Hispanic	1	0.7	0–3.9
Hispanic	95	5.0	4.1–6.2
White/Non-Hispanic	73	6.6	5.2–8.3

Esophageal Atresia/Tracheoesophageal Fistula

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	8	1.5	0.7–3.0
Black/Non-Hispanic	4	2.8	0.8–7.2
Hispanic	35	1.9	1.3–2.6
White/Non-Hispanic	21	1.9	1.2–2.9

Gastroschisis

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	10	1.9	0.9–3.5
Black/Non-Hispanic	4	2.8	0.8–7.2
Hispanic	74	3.9	3.1–4.9
White/Non-Hispanic	30	2.7	1.8–3.9

Hypospadias**

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	6	29.8	11.0–64.8
Asian/Non-Hispanic	116	42.9	35.5–51.5
Black/Non-Hispanic	36	49.4	34.7–68.4
Hispanic	304	31.8	28.3–35.6
White/Non-Hispanic	392	69.2	62.5–76.4

Limb Deficiencies

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	6	1.2	0.4–2.5
Black/Non-Hispanic	6	4.2	1.5–9.1
Hispanic	67	3.6	2.8–4.5
White/Non-Hispanic	28	2.5	1.7–3.7

Neural Tube Defects

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	3	7.7	1.6–22.5
Asian/Non-Hispanic	20	3.8	2.3–5.9
Black/Non-Hispanic	5	3.5	1.1–8.2
Hispanic	133	7.1	5.9–8.4
White/Non-Hispanic	35	3.2	2.2–4.4

Omphalocele

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	2	5.1	0.6–18.5
Asian/Non-Hispanic	6	1.2	0.4–2.5
Black/Non-Hispanic	4	2.8	0.8–7.2
Hispanic	34	1.8	1.3–2.5
White/Non-Hispanic	13	1.2	0.6–2.0

Trisomy 13

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	2	0.4	0–1.4
Black/Non-Hispanic	2	1.4	0.2–5.1
Hispanic	11	0.6	0.3–1.0
White/Non-Hispanic	8	0.7	0.3–1.4

Trisomy 18

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	0	not applicable	not applicable
Asian/Non-Hispanic	10	1.9	0.9–3.5
Black/Non-Hispanic	1	0.7	0–3.9
Hispanic	31	1.6	1.1–2.3
White/Non-Hispanic	10	0.9	0.4–1.7

Trisomy 21

Mother’s Race and Ethnicity	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Other/Non-Hispanic	10	25.7	12.3–47.2
Asian/Non-Hispanic	40	7.7	5.5–10.5
Black/Non-Hispanic	17	11.9	6.9–19.0
Hispanic	360	19.1	17.2–21.2
White/Non-Hispanic	127	11.5	9.6–13.7

*Three Year Case Count per 10,000 live births

**Hypospadias includes male or unknown gender in the numerator and male live births in the denominator

Table 4: Prevalence of Selected Birth Defects by Mother's County of Residence:2018–2020

Anopthalmia/Micropthalmia

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	9	2.1	1.0–4.0
Kern	3	0.8	0.2–2.3
Kings	0	not applicable	not applicable
Madera	1	1.6	0–8.9
Merced	2	1.7	0.2–6.3
Orange	5	0.5	0.2–1.2
San Diego	9	0.8	0.4–1.5
San Joaquin	2	0.7	0.1–2.4
Stanislaus	4	1.8	0.5–4.7
Tulare	2	1.0	0.1–3.6

Anotia/Microtia

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	21	5.0	3.1–7.6
Kern	9	2.4	1.1–4.5
Kings	0	not applicable	not applicable
Madera	3	4.8	1.0–14.0
Merced	4	3.5	0.9–8.9
Orange	33	3.3	2.2–4.6
San Diego	34	3.1	2.1–4.3
San Joaquin	9	3.0	1.4–5.8
Stanislaus	6	2.8	1.0–6.0
Tulare	11	5.4	2.7–9.7

Cleft Lip and/or Cleft Palate

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	71	16.8	13.1–21.2
Kern	76	20.0	15.8–25.0
Kings	15	21.9	12.3–36.2
Madera	13	20.8	11.1–35.5
Merced	15	13.0	7.3–21.5
Orange	135	13.3	11.2–15.8
San Diego	150	13.5	11.4–15.8
San Joaquin	49	16.6	12.3–21.9
Stanislaus	40	18.4	13.1–25.0
Tulare	43	21.2	15.3–28.5

Congenital Heart Defects

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	339	80.1	71.8–89.1
Kern	301	79.2	70.6–88.7
Kings	51	74.6	55.6–98.0
Madera	53	84.7	63.5–110.6
Merced	87	75.7	60.7–93.3
Orange	621	61.4	56.6–66.4
San Diego	844	76.0	71.0–81.3
San Joaquin	237	80.2	70.3–91.0
Stanislaus	208	95.7	83.2–109.5
Tulare	164	80.7	68.9–94.0

Craniosynostosis

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	19	4.5	2.7–7.0
Kern	11	2.9	1.4–5.2
Kings	4	5.9	1.6–15.0
Madera	4	6.4	1.7–16.4
Merced	4	3.5	0.9–8.9
Orange	56	5.5	4.2–7.2
San Diego	72	6.5	5.1–8.2
San Joaquin	8	2.7	1.2–5.3
Stanislaus	6	2.8	1.0–6.0
Tulare	9	4.4	2.0–8.4

Esophageal Atresia/Tracheoesophageal Fistula

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	8	1.9	0.8–3.7
Kern	4	1.1	0.3–2.7
Kings	1	1.5	0–8.1
Madera	3	4.8	1.0–14.0
Merced	1	0.9	0–4.8
Orange	21	2.1	1.3–3.2
San Diego	26	2.3	1.5–3.4
San Joaquin	6	2.0	0.7–4.4
Stanislaus	5	2.3	0.7–5.4
Tulare	4	2.0	0.5–5.0

Gastroschisis

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	21	5.0	3.1–7.6
Kern	15	3.9	2.2–6.5
Kings	5	7.3	2.4–17.1
Madera	3	4.8	1.0–14.0
Merced	5	4.3	1.4–10.1
Orange	28	2.8	1.8–4.0
San Diego	34	3.1	2.1–4.3
San Joaquin	6	2.0	0.7–4.4
Stanislaus	5	2.3	0.7–5.4
Tulare	14	6.9	3.8–11.6

Hypospadias**

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	91	42.1	33.9–51.7
Kern	60	30.7	23.4–39.5
Kings	12	34.7	17.9–60.5
Madera	8	24.8	10.7–48.8
Merced	22	37.6	23.6–56.9
Orange	283	54.3	48.2–61.0
San Diego	281	49.4	43.8–55.5
San Joaquin	41	27.2	19.5–36.9
Stanislaus	60	53.8	41.1–69.2
Tulare	43	42.0	30.4–56.5

Limb Deficiencies

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	19	4.5	2.7–7.0
Kern	12	3.2	1.6–5.5
Kings	3	4.4	0.9–12.8
Madera	1	1.6	0–8.9
Merced	5	4.3	1.4–10.1
Orange	32	3.2	2.2–4.5
San Diego	29	2.6	1.7–3.7
San Joaquin	11	3.7	1.9–6.7
Stanislaus	5	2.3	0.7–5.4
Tulare	10	4.9	2.4–9.1

Neural Tube Defects

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	33	7.8	5.4–11.0
Kern	40	10.5	7.5–14.3
Kings	5	7.3	2.4–17.1
Madera	5	8.0	2.6–18.6
Merced	12	10.4	5.4–18.2
Orange	62	6.1	4.7–7.9
San Diego	57	5.1	3.9–6.6
San Joaquin	24	8.1	5.2–12.1
Stanislaus	19	8.7	5.3–13.6
Tulare	24	11.8	7.6–17.6

Omphalocele

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	11	2.6	1.3–4.7
Kern	7	1.8	0.7–3.8
Kings	0	not applicable	not applicable
Madera	0	not applicable	not applicable
Merced	3	2.6	0.5–7.6
Orange	23	2.3	1.4–3.4
San Diego	20	1.8	1.1–2.8
San Joaquin	10	3.4	1.6–6.2
Stanislaus	1	0.5	0–2.6
Tulare	4	2.0	0.5–5.0

Trisomy 13

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	7	1.7	0.7–3.4
Kern	2	0.5	0.1–1.9
Kings	2	2.9	0.4–10.6
Madera	1	1.6	0–8.9
Merced	2	1.7	0.2–6.3
Orange	11	1.1	0.5–1.9
San Diego	7	0.6	0.3–1.3
San Joaquin	3	1.0	0.2–3.0
Stanislaus	4	1.8	0.5–4.7
Tulare	5	2.5	0.8–5.7

Trisomy 18

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	11	2.6	1.3–4.7
Kern	7	1.8	0.7–3.8
Kings	3	4.4	0.9–12.8
Madera	1	1.6	0–8.9
Merced	4	3.5	0.9–8.9
Orange	37	3.7	2.6–5.0
San Diego	22	2.0	1.2–3.0
San Joaquin	10	3.4	1.6–6.2
Stanislaus	3	1.4	0.3–4.0
Tulare	5	2.5	0.8–5.7

Trisomy 21

Mother’s County of Residence	Three Year Case Count	Prevalence Rate*	95% Confidence Interval
Fresno	78	18.4	14.6–23.0
Kern	61	16.1	12.3–20.6
Kings	10	14.6	7.0–26.9
Madera	10	16.0	7.7–29.4
Merced	16	13.9	8.0–22.6
Orange	185	18.3	15.7–21.1
San Diego	181	16.3	14.0–18.8
San Joaquin	69	23.3	18.2–29.5
Stanislaus	40	18.4	13.1–25.0
Tulare	33	16.2	11.2–22.8

*Three Year Case Count per 10,000 live births

**Hypospadias includes male or unknown gender in the numerator and male live births in the denominator

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California Birth Defects Monitoring

California Birth Defects Monitoring Program (CBDMP) Birth Defects Report Summary

Table 1: Overall Prevalence of Selected Birth Defects: 2018–2020

Table 2: Prevalence of Selected Birth Defects by Mother’s Age: 2018–2020

Anopthalmia/Micropthalmia

Anotia/Microtia

Cleft Lip and/or Cleft Palate

Congenital Heart Defects

Craniosynostosis

Esophageal Atresia/Tracheoesophageal Fistula

Gastroschisis

Hypospadias**

Limb Deficiencies

Neural Tube Defects

Omphalocele

Trisomy 13

Trisomy 18

Trisomy 21

Table 3: Prevalence of Selected Birth Defects by Mother's Race and Ethnicity: 2018–2020

Anopthalmia/Micropthalmia

Anotia/Microtia

Cleft Lip and/or Cleft Palate

Congenital Heart Defects

Craniosynostosis

Esophageal Atresia/Tracheoesophageal Fistula

Gastroschisis

Hypospadias**

Limb Deficiencies

Neural Tube Defects

Omphalocele

Trisomy 13