Tennessee Birth Defects Surveillance
TNBDSS is a statewide surveillance program that monitors key birth defect diagnoses and provides information on trends, risk factors, and supportive services.About the Tennessee Birth Defects Surveillance System
What is a Birth Defect?
Birth defects, also called congenital anomalies, are conditions that can affect almost any part of the body. They may change how the body looks, how it works, or both.
Birth defects can be identified:
- Before birth
- At birth
- After birth
Birth defects vary in severity. Some are mild, while others are more serious. Life expectancy can differ depending on how severe the birth defect is and which body part or system is affected.
Early identification and response to birth defects often support early intervention and treatment. Early care may reduce complications and long-term disability.
What Causes Birth Defects?
The causes of many birth defects are not fully known. In many cases, birth defects may result from one or more factors acting together.
Possible causes and contributing factors include:
- Genetic factors, such as inherited conditions or changes in genes or chromosomes
- Environmental exposures, including pollutants or toxic substances
- Workplace (occupational) hazards
- Certain medications taken during pregnancy
- Poor nutrition or lack of key vitamins before or during pregnancy
- Infections during pregnancy
- Modifiable personal behaviors, such as tobacco use, alcohol use, or substance use
Not all birth defects can be prevented. However, identifying risk factors and promoting healthy behaviors before and during pregnancy may reduce the risk of some birth defects.
How Common are Birth Defects?
According to the Centers for Disease Control and Prevention (CDC), nearly 1 out of every 33 babies in the United States is born with a birth defect.
What Does the Tennessee Birth Defects Surveillance System Do?
A birth defects surveillance and information system is important for developing programs and policies that help reduce birth defects and infant mortality. These programs also help connect families to services and support within their communities.
The Tennessee Birth Defects Surveillance System (TNBDSS) is a statewide program within the Tennessee Department of Health. TNBDSS is authorized by Tennessee Code Annotated (TCA) §68-5-506 and works to:
- Identify children with birth defects
- Provide information on the incidence, prevalence, and trends of birth defects
- Inform partners and the public about birth defects and related risk factors
- Support prevention efforts
- Provide families with information about available supportive services in Tennessee
- Make service referrals when appropriate
What Does the State Do With Birth Defects Data?
Birth defects information is collected and securely maintained by the Tennessee Department of Health.
The Tennessee Birth Defects Surveillance System (TNBDSS) uses this information to:
- Monitor and understand birth defects across Tennessee
- Identify trends and support prevention efforts
- Inform programs, policies, and public health planning
TNBDSS produces a birth defects report each year. These reports:
- Do not include any information that identifies a baby or individual
- Present data only in summary form to protect privacy
Contact Information
If you have questions about TNBDSS, data use, or available resources, please contact the program.
Email: Birth.Defects@tn.gov
For Families
Can I Reduce the Risk of Birth Defects?
Although not all birth defects can be prevented, there are steps you can take before and during pregnancy to help improve your chances of a healthy pregnancy.
According to the Centers for Disease Control and Prevention (CDC), the following actions may help reduce risk and support healthy outcomes.
Plan Ahead
- Get as healthy as possible before becoming pregnant
- Discuss reproductive life planning with your partner and health care provider
- Take 400 micrograms (mcg) of folic acid every day
- See a health care professional regularly
Avoid Harmful Substances
- Avoid smoking
- Learn about the GIFTS Program and the Tennessee Quit Line
- Avoid drinking alcohol
- Avoid marijuana and other illicit substances
- Seek support for substance use disorders through the Tennessee Department of Mental Health and Substance Abuse Services
- Be cautious of harmful exposures at work and at home
- Avoid infections and seek medical care for suspected illnesses, including sexually transmitted infections (STIs)
Choose a Healthy Lifestyle
- Manage chronic health conditions, such as diabetes, high blood pressure, and mental health needs
- Work toward and maintain a healthy weight
- Eat a balanced diet that includes fruits, vegetables, whole grains, low-fat dairy, and lean proteins
- Stay physically active, as recommended by your health care provider
Talk to Your Health Care Provider About:
- Getting routine medical checkups
- All medications you take, including prescription, over-the-counter, and supplements
- Your family health history
- Vaccinations
Travel During Pregnancy
- Discuss any travel plans with your health care provider before and during pregnancy
For the most current information, visit the Centers for Disease Control and Prevention (CDC) website.
Preconception
Before pregnancy, focus on reproductive planning, improving health behaviors, managing chronic conditions, starting folic acid supplementation, and planning and spacing pregnancies.
Prenatal
During pregnancy, maintain a balanced diet, take prenatal vitamins, avoid alcohol and substances that may harm the pregnancy, and discuss all medications and supplements with your provider.
Perinatal
Continue avoiding tobacco, alcohol, and illicit substances. Discuss your birth plan with your provider and plan for your child’s medical home and care needs.
Babies
Ensure your baby receives needed medical care, including routine well-baby visits. Explore supportive services to help manage care needs and possible financial burdens.
Children
Continue routine Well-Child visits. Consider referral to the Tennessee Early Intervention System (TEIS) for services for young children with developmental delays or disabilities.
Transition to Adulthood
Support services are available for adolescents and adults with disabilities or chronic health conditions. Continue to use community and state resources to support long-term health and independence.
What Support Is Available If My Child Has a Birth Defect?
The following programs and resources may provide support, information, and services for children with birth defects and their families.
External Links Disclaimer
Some of the links below direct you to third-party websites that are not maintained by the Tennessee Department of Health (TDH). TDH does not control or guarantee the accuracy, relevance, timeliness, or accessibility of information on these external sites and is not responsible for their content or functionality.
- Children’s Special Services (CSS)
Provides care coordination and support services for children with special health care needs and their families. - Tennessee Early Intervention System (TEIS)
Offers early intervention services for infants and toddlers with developmental delays or disabilities. - Family Voices of Tennessee
Supports families of children with special health care needs through education, advocacy, and family-centered care resources. - KidCentral Tennessee
Provides information and resources for families related to child development, health, and early learning. - Tennessee Disability Pathfinder
Helps individuals with disabilities and their families find services, programs, and support available in Tennessee. - March of Dimes
Offers education, support, and advocacy focused on improving maternal and infant health outcomes. - Medical Home Approach (View the Medical Home tab on the CYSHCN page)
Promotes coordinated, family-centered care that addresses a child’s medical, developmental, and social needs. - Partnering With Your Doctor Booklet English | Spanish
Provides guidance to help families communicate effectively with health care providers.
This document is not authorized for external print or distribution.
For additional information, including diagnosis-specific resources, visit the Media & Resources tab.
For Providers
This page provides health care providers with reporting requirements, referral tools, educational resources, and clinical information related to birth defects in Tennessee.
Zika-Related Birth Defects: Mandatory Reporting
Effective January 1, 2017, mandatory reporting requirements for microcephaly were expanded to include additional specified neurologic birth defects.
Providers may review:
- The complete list of reportable birth defects (2017)
- View detailed birth defect reporting requirements in the Laws and Regulations tab
- The Letter of Public Health Authority (2017)
- Instructions for reporting a birth defect to the Tennessee Department of Health
Additional Birth Defects Information
External Links Disclaimer
The following links direct you to third-party websites that are not maintained by the Tennessee Department of Health (TDH). TDH does not control or guarantee the accuracy, relevance, timeliness, or accessibility of information on these external sites and is not responsible for their content or functionality.
Centers for Disease Control and Prevention (CDC) Birth Defects Information
National Birth Defects Prevention Network
March of Dimes Birth Defects Resources
Down Syndrome: Understanding Your Patient’s Diagnosis (provider pamphlet)
Resources for Transforming Your Practice to a Patient-Centered Medical Home
External Links Disclaimer
Some of the links below direct you to third-party websites that are not maintained by the Tennessee Department of Health (TDH). TDH does not control or guarantee the accuracy, relevance, timeliness, or accessibility of information on these external sites and is not responsible for their content or functionality.
NCQA-Certified Patient-Centered Medical Homes
American Academy of Pediatrics (AAP) Medical Home Resources
View the Medical Home tab on the Children and Youth with Special Health Care Needs (CYSHCN) page
Partnering With Your Doctor Booklet
Data, Reports, and Publications
This section provides access to Tennessee birth defects data, annual reports, fact sheets, publications, and recordings from the Tennessee Birth Defects Registry Advisory Committee meetings.
Annual Reports
Fact Sheets
Publications
External Links Disclaimer
The following links direct you to third-party websites that are not maintained by the Tennessee Department of Health (TDH). TDH does not control or guarantee the accuracy, relevance, timeliness, or accessibility of information on these external sites and is not responsible for their content or functionality.
Zika-Associated Birth Defects Reported in Pregnancies with Laboratory Evidence of Confirmed or Possible Zika Virus Infection
CDC Morbidity and Mortality Weekly Report (MMWR)
Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015
Tennessee Birth Defects Registry Advisory Committee Meeting Recordings
Birth Defects Data Dashboard
This dashboard provides interactive data on reported birth defects in Tennessee, allowing users to explore counts and trends by county and selected characteristics.
Laws and Regulations
Mandatory Reporting of Birth Defects
Federal and state laws require the reporting of certain birth defects to support public health surveillance, prevention efforts, and service planning.
Health care providers and hospital administrators are required to comply with these reporting laws.
If you are a provider or hospital administrator, please review the letter from the Tennessee Commissioner of Health for additional reporting guidance.
Laws Governing Reportable Birth Defects
Federal Law
Under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, covered entities may share protected health information with public health authorities when authorized by law.
Legal Text — 45 Code of Federal Regulations (CFR) § 164.512(b):
“Covered entities such as hospitals may disclose, without individual authorization, protected health information to a public health authority that is authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events such as birth or death and the conduct of public health surveillance, public health investigations, and public health interventions…”
Tennessee State Law
Birth Defects Registry
Tennessee Code Annotated (TCA) § 68-5-506: This statute authorizes the Tennessee Department of Health to collect information related to birth defects through the Tennessee Birth Defects Surveillance System.
Administrative Rule
Legal Text — Rule 1200-14-01-.26:
“No person shall interfere with or obstruct… the examination of any relevant record, by the responsible health officer, his duly authorized agent or a representative of the department in the proper discharge of his or her official duties under these Rules.”
Questions About Reporting or Compliance?
If you have questions about reporting requirements or legal authority, please contact the Tennessee Birth Defects Surveillance System.
Email: Birth.Defects@tn.gov
Media and Resources
This section provides access to media content and educational resources related to birth defects, including social media posts, press releases, diagnosis-specific information, and additional Tennessee Department of Health resources.
Social Media Posts
The following links provide examples of social media messaging related to healthy pregnancies and birth defects.
Additional Resources
External Links Disclaimer
Some of the links below direct you to third-party websites that are not maintained by the Tennessee Department of Health (TDH). TDH does not control or guarantee the accuracy, relevance, timeliness, or accessibility of information on these external sites and is not responsible for their content or functionality.
American College of Medical Genetics and Genomics
An organization of health care professionals committed to the practice of medical genetics.
American Academy of Pediatrics
A professional organization dedicated to ensuring the health and well-being of all children.
American College of Obstetricians and Gynecologists
A professional organization for obstetrician-gynecologists focused on improving women’s health care through education, advocacy, and research.
Birth Defect Research for Children
A nonprofit organization that provides parents and expectant parents with information about birth defects and available support services.
Centers for Disease Control and Prevention (CDC) – Birth Defects
Provides information on identifying causes of birth defects, prevention efforts, and improving the health of individuals living with birth defects.
Children’s Heart Foundation
An organization dedicated to funding research on congenital heart defects.
Disabled Children’s Relief Fund
Supports children with disabilities by helping provide tools and resources to promote independence and community inclusion.
HHS Women’s Health Information Center
Coordinates women’s health efforts across the U.S. Department of Health and Human Services and provides health information for women and families.
Healthfinder
Offers trusted health information to help individuals and families make informed health decisions.
Mended Little Hearts
Provides peer-to-peer support, education, and advocacy for children with heart conditions and their families.
March of Dimes
A nonprofit organization focused on preventing maternal and infant health risks, preterm birth, and infant death while promoting health equity.
MotherToBaby
Provides evidence-based information on the safety of medications and other exposures during pregnancy and breastfeeding.
National Birth Defects Prevention Network
A volunteer-based organization that supports birth defects surveillance, research, and prevention through a national network of programs.
National Organization for Rare Disorders (NORD)
A nonprofit organization that serves as a clearinghouse for information on rare disorders.
Pediatric Orthopaedic Society of North America (POSNA)
A professional organization dedicated to advancing musculoskeletal care for children through education, research, advocacy, and outreach.
Tennessee Disability Pathfinder
Helps individuals with disabilities, families, educators, and professionals find and access disability-related resources and services in Tennessee.
Craniofacial Conditions
American Cleft Palate-Craniofacial Association
Advances patient care and research for individuals affected by cleft lip, cleft palate, and other craniofacial conditions.
Children’s Craniofacial Association
Addresses the medical, financial, psychosocial, emotional, and educational needs of individuals with craniofacial conditions and their families.
Congenital Heart Defects
American Heart Association
Provides information on congenital heart defects, which are abnormalities of the heart’s structure or function present at birth.
Children’s Heart Foundation
Funds research focused on congenital heart defects.
Neurologic and Spinal Conditions
American Syringomyelia and Chiari Alliance Project (ASAP)
Works to improve the lives of individuals affected by syringomyelia, Chiari malformation, and related disorders through support, education, and research.
Spina Bifida Association
Promotes a better future for individuals impacted by spina bifida through education, advocacy, research, and support.
Spina Bifida Resource Network
Provides services and programs for individuals and families affected by spina bifida and other disabilities.
Down Syndrome Resources
National Down Syndrome Society (NDSS)
Works to ensure people with Down syndrome have opportunities to improve quality of life and achieve their goals.
National Association for Down Syndrome
Supports individuals with Down syndrome in reaching their full potential.
Chattanooga Down Syndrome Society
Clarksville Association for Down Syndrome
Down Syndrome Association of Memphis and the Mid-South
Down Syndrome Association of Middle Tennessee
Down Syndrome Association of West Tennesse
Down Syndrome Awareness Group of East Tennessee
Friends Reaching, Inspiring, and Educating Neighbors About Down Syndrome (FRIENDS) – East Tennessee
Down Syndrome Parents Pamphlet
Provides information and support for parents of children with Down syndrome.
Gastrointestinal and Abdominal Conditions
Esophageal Atresia Global Support Groups
Supports individuals with esophageal atresia by promoting awareness, shared knowledge, and global research collaboration.
Global Gastroschisis Foundation
Supports research, awareness, and families affected by gastroschisis.
Hearing and Vision Conditions
Hearing Loss Association of America (HLAA)
Provides information, education, support, and advocacy for individuals with hearing loss.
ICAN: The International Children’s Anophthalmia Network
Offers referrals, education, and support for individuals affected by anophthalmia and microphthalmia.
Limb Differences and Mobility Conditions
Limbless Association
Provides information, advice, and support for amputees, their families, and professionals.
Muscular and Neuromuscular Disorders
Muscular Dystrophy Association
Advances research, care, and advocacy for individuals living with muscular dystrophy, ALS, and related neuromuscular diseases.
Other Conditions
Incredible Teddy Foundation: Congenital Diaphragmatic Hernia Support
Supports families affected by congenital diaphragmatic hernia through education, awareness, and financial assistance.
United Cerebral Palsy of Middle Tennessee
Advances independence and full participation for individuals with cerebral palsy and other disabilities through programs and services.
- Children’s Special Services (CSS)
Provides care coordination and support services for children with special health care needs and their families. - Community Health and Navigation in Tennessee (CHANT)
Connects individuals and families to health care services and community-based resources across Tennessee. - Pregnancy Smoking Cessation (View the Cessation tab on the TUPCP page)
Supports pregnant individuals with resources and services to help quit smoking and improve pregnancy outcomes. - Project Diabetes
Promotes diabetes prevention and management through education, screening, and community-based initiatives. - Tennessee Early Intervention System (TEIS)
Provides services and supports for infants and toddlers with developmental delays or disabilities and their families. - Tennessee QUIT Line (View the Cessation tab on the TUPCP page)
Offers free support and resources to help Tennesseans quit tobacco use. - Tennessee Women, Infants, and Children (WIC)
Provides nutrition education, breastfeeding support, and healthy foods for eligible women, infants, and children.
This Page Last Updated: March 26, 2026 at 3:48 PM