Congenital malformations surveillance: two American systems.

As part of its epidemiologic studies of congenital malformations, the Centers for Disease Control (CDC) conducts two birth defects surveillance systems in the United States. The Metropolitan Atlanta Congenital Defects Programme (MACDP) is an intensive surveillance system using several methods to identify infants born with birth defects in the Atlanta area. The Birth Defects Monitoring Programme (BDMP) is a nationwide surveillance system that monitors 1 million births per year, about a third of all births in the U.S. It relies on diagnoses from newborn discharge summaries to ascertain affected infants. The systems were originally designed to detect potential 'epidemics' of birth defects that could occur following the widespread dissemination of new teratogens similar to thalidomide. In addition to monitoring, they have also proved to be useful resources for a variety of studies of the epidemiology of birth defects.