BackgroundEmerging evidence suggests newborn screening analytes may yield insights into the etiologies of birth defects, yet no effort has evaluated associations between a range of newborn screening analytes and birth defects.MethodsThis population-based study pooled statewide data on birth defects, birth certificates, and newborn screening analytes from Texas occurring between January 1, 2007 and December 31, 2009. Associations between a panel of thirty-six newborn screening analytes, collected by the statewide Texas Newborn Screening Program, and the presence of a birth defect, defined as at least one of 39 birth defects diagnoses recorded by the Texas Birth Defects Registry, were assessed using regression analysis.FindingsOf the 27,643 births identified, 20,205 had at least one of the 39 birth defects of interest (cases) as identified by the Texas Birth Defects Registry, while 7,438 did not have a birth defect (controls). Among 1,404 analyte-birth defect associations evaluated, 377 were significant in replication analysis. Analytes most consistently associated with birth defects included the phenylalanine/tyrosine ratio (N = 29 birth defects), tyrosine (N = 28 birth defects), and thyroxine (N = 25 birth defects). Birth defects most frequently associated with a range of analytes included gastroschisis (N = 29 analytes), several cardiovascular defects (N = 26 analytes), and spina bifida (N = 23 analytes).ConclusionsSeveral significant and novel associations were observed between newborn screening analytes and birth defects. While some findings could be consequences of the defects themselves or to the care provided to infants with these defects, these findings could help to elucidate mechanisms underlying the etiology of some birth defects.

The cost of giving birth through cesarean section in the United States varies significantly by state and insurance status. In 2023, the national median charge for a C-section delivery for those without insurance, or using out-of-network services, was ****** U.S. dollars, with New Jersey topping the list of the highest costs at ****** U.S. dollars.
Insurance impact on c-section costs Having insurance significantly reduces the financial burden of childbirth. The national median allowed value for insured, in-network C-sections was ****** U.S. dollars in 2023, less than half the cost for uninsured patients. Even with insurance, costs vary widely by state, with New Jersey again having the highest median allowed value at ****** U.S. dollars. The disparity between insured and uninsured costs underscores the importance of healthcare coverage for expectant mothers. C-section rates and reasons C-section rates in the United States remain higher than national targets. In 2024, the average C-section rate for low-risk first-time mothers was **** percent, above the national target of **** percent. Among all live births, the C-section rate was even higher, at **** percent in 2023. A 2023 survey revealed that about a ******* of women who had C-sections in the past six months did so due to previous C-sections, while over **** reported having emergency C-sections.

Top 50 significanta newborn screening analytes across all birth defects.

Top 15 significanta newborn screening analytes for isolated gastroschisis and isolated transposition of the great vessels.

Study population characteristics by case/control status (N = 27,643) (Texas, 2007–2009).