Examination after delivery, or at the second physical examination before mother and child are discharged from the hospital. Coding was performed by staff members of the Department of Mother and Child Health and the Department of Community Genetics using standardized coding (ICD-10codes).About80% of the diagnosed congenital malformations cases are recorded by the registry(Amitai, 2007). The birth defect data set included information regarding live births, stillbirths and pregnancies terminated after the 20th gestational week. Fetal deaths and spontaneous abortions prior to the 20th gestational week are not routinely recorded in Israel.