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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.

From 278 interviews of women who had infants with selected major malformations, a history of diazepam ingestion in the first trimester of pregnancy was found to be four times more frequent among mothers of children with a cleft lip with or without a cleft palate than among mothers of children with other defects. This association was one of many that was examined in the analysis; thus it is quite possible that it is simply due to chance. This report, however, is the second one linking diazepam to cleft lip with or without cleft palate. Until there are more data bearing on this question, this possible risk should be considered when prescribing diazepam for women in their reproductive years.