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Why Is This Important?
Birth defects pose a significant public health problem. One in 33 babies is born with a structural birth defect in the United States. Birth defects are a leading cause of infant mortality and responsible for considerable morbidity with enormous economic and social costs. Infants and young children with tetralogy of Fallot often have blue- or purplish-looking skin color, called cyanosis, because of oxygen-poor blood. At birth, infants might not have blue-looking skin, but later might develop sudden episodes (called "Tet spells") of bluish skin during crying or feeding. Many babies with this condition will have to have surgery to correct it. Babies who have surgery usually do well. Unfortunately, without surgery, death usually occurs before the person reaches 20 years of age. The following are a few of the issues that people with tetralogy of Fallot might have to face: children with this condition might need to limit their physical activity, especially in competitive sports; people with tetralogy of Fallot are at increased risk for developing endocarditis (an infection of the inner layer of the heart); people with repaired tetralogy of Fallot have a higher risk of heart rhythm disturbances, called arrhythmias. Sometimes these can cause dizziness or fainting. Medicine or medical procedures might be needed to address these issues; people with tetralogy of Fallot can have delayed growth and development; and people with tetralogy of Fallot can have seizures during periods when insufficient oxygen is being carried in the blood.
Tetralogy of Fallot is a problem with the heart's structure that is present at birth. This defect changes the normal flow of blood through the heart. Tetralogy of Fallot is a combination of four defects: a hole in the wall between the ventricles (two lower chambers of the heart), called a ventricular septal defect; narrowing of the tube that carries blood from the heart to the lungs, called pulmonary stenosis; the aorta (the tube that carries oxygen-rich blood to the body) grows from both ventricles, rather than from the left ventricle only; and a thickened muscular wall of the right ventricle, called right ventricular hypertrophy. Prevalence of tetralogy of Fallot is the number of live-born infants with tetralogy of Fallot per 10,000 live born infants. (Live-born infants are the infants born with any evidence of life). New Mexico live-born infants with tetralogy of Fallot, 2015-2019.
Data NotesThe following International Classification of Diseases, 9th and 10th Revisions Clinical Modification (ICD-9-CM and ICD-10-CM) codes were used in 2015 to identify tetralogy of Fallot: 745.2 and Q21.3, respectively. Only ICD-10-CM code was used from 2016-2019. In 1987, CDC put forth a set of 6-digit codes (the sixth digit provides greater specificity for diagnosis) based on the British Pediatric Association Classification of Diseases and the ICD-9-CM. If CDC/BPA codes are present, the following were used to identify tetralogy of Fallot: 745.20-745.21, 747.31.
- Birth Defects Prevention and Surveillance System (BDPASS), New Mexico Department of Health.
- Birth Certificate Data, Bureau of Vital Records and Health Statistics (BVRHS), Epidemiology and Response Division, New Mexico Department of Health.
How the Measure is Calculated
Numerator:Number of live-born infants with tetralogy of Fallot.
Denominator:Number of live-born infants.
Birth Defects Prevention and Surveillance System (BDPASS)
Birth defects are reported on the birth certificates, which are provided for all births occurring in-state as well as births to NM resident mothers who gave birth out-of-state. Some birth defects (Hypoplastic Left Heart Syndrome, Tetralogy of Fallot, Transposition of Great Arteries, Hypospadias, Lower and Upper Limb Deficiencies, and Trisomy 21) were not reported on birth certificates until 2004.
Birth Certificate Data
Birth certificate information is submitted electronically by hospital medical records staff who use standard mother and facility worksheets and medical charts to collect the needed information. Training of hospital staff is provided by the Bureau of Vital Records and Health Statistics (BVRHS). The birth certificate information is reviewed by BVRHS for completeness and consistency with state law and NMDOH and national guidelines. BVRHS will contact hospital staff for clarification of missing, inconsistent or incorrect entries. CDC's National Center for Health Statistics provides feedback to BVRHS on data quality and the NMDOH provides feedback to the hospitals to improve data quality and training.