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22 U.S. jurisdictions included births that occurred in California (selected counties), Florida (selected southern counties), Georgia (selected metropolitan Atlanta counties), Hawaii, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Minnesota, New Jersey, New York (excluding New York City residents), North Carolina (selected regions), Oklahoma, Puerto Rico, Rhode Island, South Carolina, Texas (Public Health Regions 10, 11), the U.S. Virgin Islands, Utah, Vermont, and Virginia.

* Congenital microcephaly (head circumference <3rd percentile for gestational age and sex and documentation of microcephaly or a small head in the medical record), intracranial calcifications, cerebral atrophy, abnormal cortical gyral patterns (e.g., polymicrogyria, lissencephaly, pachygyria, schizencephaly, gray matter heterotopia), corpus callosum abnormalities, cerebellar abnormalities, porencephaly, hydranencephaly, ventriculomegaly/hydrocephaly (excluding “mild” ventriculomegaly without other brain abnormalities), fetal brain disruption sequence (collapsed skull, overlapping sutures, prominent occipital bone, scalp rugae), and other major brain abnormalities.

** § Microphthalmia/anophthalmia, coloboma, cataract, intraocular calcifications, and chorioretinal anomalies (e.g., atrophy and scarring, gross pigmentary changes, excluding retinopathy of prematurity); optic nerve atrophy, pallor, and other optic nerve abnormalities.