NOTES:
- Birth defect races/Hispanic ethnicity were revised in 2026 to match the race and ethnicity on the Vital Records birth certificates.
Where no birth certificate is available (e.g., Intrauterine fetal demise) OBDR race/ethnicity was used.
- The OBDR utilizes an adapted British Pediatric Association (BPA) coding system for classification of birth defects.
These codes consist of a 6-digit number which identifies the specific birth defect. Importantly, if a code ends in '8' e.g. 742.108,
it is considered unconfirmed and is excluded from the presented figures.
| Modified | | |
| Code | Birth Defect | BPA Code |
| | | |
| | Cardiovascular (CVS) | |
| AA01 | Aortic valve stenosis | 746300-746309 |
| AA02 | Atrial septal defect | 745510-745599 |
| AA03 | Atrioventricular septal defect (Endocardial cushion defect) | 745600-745699 or 745487 |
| AA04 | Coarctation of the aorta | 747100-747199 |
| AA05 | Common truncus (truncus arteriosus or TA) | 745000-745009 |
| AA06 | Double outlet right ventricle (DORV) | 745130-745159 |
| AA07 | Ebstein anomaly | 746200-746209 |
| AA08 | Hypoplastic left heart syndrome | 746700-746709 |
| AA09 | Interrupted aortic arch (IAA) | 747215-747217 or 747285 |
| AA10 | Pulmonary valve atresia and stenosis | 746000-746019 |
| AA11 | Single Ventricle | 745300-745309 |
| AA12 | Tetralogy of Fallot (TOF)/Trilogy of Fallot | 745200-745219 or 747310-747319 |
| AA13 | Total anomalous pulmonary venous connection (TAPVC) | 747420-747429 |
| AA14 | Transposition of the great arteries (TGA) | 745100-745129 or 745180-745199 |
| AA15 | Tricuspid valve atresia and stenosis | 746100-746104 or 746106 |
| AA16 | Ventricular septal defect | 745400-745486 or 745489-745499 |
|
|
|
| | Orofacial (ORF) | |
| BB01 | Choanal atresia | 748000-748009 |
| BB02 | Cleft lip with cleft palate | 749200-749299 |
| BB03 | Cleft lip alone (without cleft palate) | 749100-749199 |
| BB04 | Cleft palate alone (without cleft lip) | 749000-749099 |
|
|
|
| | Eye (EYE) | |
| CC01 | Anophthalmia/microphthalmia | 743000-743109 |
| CC02 | Congenital cataract | 743320-743329 |
|
|
|
| | Ear (EAR) | |
| DD01 | Anotia/microtia | 744010-744019 or 744210-744219 |
|
|
|
| | Gastrointestinal (GSI) | |
| EE01 | Biliary atresia | 751650-751659 |
| EE02 | Esophageal atresia/tracheoeosophageal fistula | 750300-750359 |
| EE03 | Rectal and large intestinal atresia/stenosis | 751200-751249 |
| EE04 | Small intestinal atresia/stenosis | 751100-751199 |
|
|
|
| | Central Nervous System (CNS) | |
| FF01 | Anencephalus | 740000-740109 |
| FF02 | Spina bifida without anencephalus | 741000-741999 and BPA not equal to 740000-740109 |
| FF03 | Encephalocele | 742000-742099 |
| FF04 | Holoprosencephaly | 742260-742269 |
|
|
|
| | Genitourinary (GTU) | |
| GG01 | Bladder exstrophy | 753500-753509 |
| GG02 | Congenital posterior urethral valves | 753600-753609 |
| GG03 | Hypospadias | 752600-752609 or 752620 or 752622-752629 |
| GG04 | Renal agenesis/hypoplasia | 753000-753019 |
| GG05 | Cloacal exstrophy | 751555 |
|
|
|
| | Musculoskeletal (MSK) | |
| HH01 | Clubfoot | 754500-754509 or 754730-754734 or 754736-754739 |
| HH02 | Craniosynostosis | 756000-756039 |
| HH03 | Diaphragmatic hernia | 756610-756617 |
| HH04 | Gastroschisis | 756710-756719 |
| HH05 | Limb deficiencies (reduction defects) | 755200-755499 |
| HH06 | Omphalocele | 756700-756709 |
|
|
|
| | Chromosomal (CHR) | |
| II01 | Deletion 22 q11 | 758370-758379 |
| II02 | Trisomy 13 | 758100-758199 |
| II03 | Trisomy 18 | 758200-758299 |
| II04 | Trisomy 21 (Downs syndrome) | 758000-758099 |
| II05 | Turner syndrome | 758600-758699 |
|
|
|
Notable Surveillance Changes:
- A greater than 4mm measurement criterion for atrial septal defects was introduced in 2014. However, strict adherence was not achieved until birth year 2016.
- Tetralogy of Fallot
- Includes:
- Tetralogy of Fallot
- Pentalogy of Fallot – Tetralogy of Fallot with an associated inter-atrial communication, either a patent foramen ovale or an atrial septal defect.
- Pulmonary atresia with VSD, which is similar to severe forms of Tetralogy of Fallot and is included for surveillance.
- Previously included Trilogy of Fallot (746840) but are now excluded from the presented figures.
- Cloacal exstrophy surveillance began in 2016.
Multiple Birth Defects in the Same Child
An infant or fetus can have multiple birth defects. For example, an infant/fetus with a cleft lip and spina bifida is counted when cleft lip is queried and is counted
when spina bifida is queried. Therefore, the total of the two queries should not be added together to reach a total number of infants/fetuses.
Birth Prevalence (expressed as the number of cases of a birth defect of interest per a standard number of live births)
Ideally, incidence rates would be used instead of prevalence to measure birth defect occurrence. Since the number of conceptions is unknown, as is the number of cases “lost” through spontaneous abortions,
technically speaking we cannot determine incidence. Because of this, most individuals working in the area of birth defects use the term ‘birth prevalence’ to refer to birth defect occurrence.
The formula for birth prevalence (expressed as the number of cases of a defect of interest per 10,000 live births):
The number of infants with the birth defect of interest in an area and time period / by the number of live births in the same area and time period * 10,000
EXAMPLE: 62 cases of hypoplastic left heart syndrome statewide delivered in 2009-2013 / 266,073 live births in 2009-2013 = 2.33 cases per 10,000 live births
The county of residence at the time of delivery.
| Region
| Counties |
| Central |
Cleveland, Oklahoma |
| Northeast |
Adair, Cherokee, Craig, Creek, Delaware, Kay, Lincoln, Mayes, Muskogee, Noble, Nowata, Okfuskee, Okmulgee, Osage, Ottawa,
Pawnee, Payne, Rogers, Sequoyah, Wagoner, Washington |
| Northwest |
Alfalfa, Beaver, Blaine, Canadian, Cimarron, Custer, Dewey, Ellis, Garfield, Grant, Harper, Kingfisher, Logan, Major, Roger Mills, Texas,
Woods, Woodward |
| Southeast |
Atoka, Bryan, Choctaw, Coal, Haskell, Hughes, Johnston, Latimer, LeFlore, Marshall, McCurtain, McIntosh, Murray, Pittsburg, Pontotoc, Pottawatomie, Pushmataha, Seminole |
| Southwest |
Beckham, Caddo, Carter, Comanche, Cotton, Garvin, Grady, Greer, Harmon, Jackson, Jefferson, Kiowa, Love, McClain, Stephens, Tillman, Washita |
| Tulsa |
Tulsa
|
Metropolitan and Micropolitan Statistical Areas
(Map of Metropolitan and Micropolitan Statistical Areas)
The Centers for Medicare and Medicaid Services use these geographic designations for their programs. They are county based using Census Bureau metropolitan and micropolitan definitions.
Metropolitan and Micropolitan definitions may be found at
Metro/Micro Definitions.
| Area
| Counties
|
| Metropolitan |
Canadian, Cleveland, Comanche, Cotton, Creek, Garfield, Grady, Lincoln, Logan, McClain, Oklahoma, Okmulgee, Osage, Pawnee, Rogers, Sequoyah, Tulsa, Wagoner |
| Micropolitan |
Beckham, Bryan, Carter, Cherokee, Custer, Jackson, Kay, Muskogee, Ottawa, Payne, Pittsburg, Pontotoc, Pottawatomie, Stephens, Texas, Washington, Washita, Woodward |
| Rural |
Adair, Alfalfa, Atoka, Beaver, Blaine, Caddo, Choctaw, Cimarron, Coal, Craig, Delaware, Dewey, Ellis, Garvin, Grant, Greer, Harmon, Harper, Haskell, Hughes, Jefferson,
Johnston, Kingfisher, Kiowa, Latimer, Leflore, Love, McCurtain, McIntosh, Major, Marshall, Mayes, Murray, Noble, Nowata, Okfuskee, Pushmataha, Roger Mills, Seminole, Tillman, Woods |
