Spurious high birth defect rate on the island of Lanai and an unexpected indication of a high incidence of adverse pregnancy outcomes in Kohala on the Big Island.

The previously reported high birth defect rate from 1968-1982 on the island of Lanai in Hawaii was found to be due to incomplete recording of birth defects on birth certificates elsewhere in the state. The elevated birth defect rate and low birth weight rate for the area of Kohala on the big island were without obvious explanations and were sufficiently high to warrant further study.