Statewide birth certificate and preschool exceptionality records were integrated to identify risk factors for developmental delay (DD). Epidemiological methods were used to investigate both individual-level and population-level risk for DD associated with a number of child and maternal factors. Infants born with very low birth weight were at the greatest individual-level risk for DD, whereas prematurity (gestational age less than 37 weeks) and low maternal education posed the greatest population-level risk. For comparative purposes, individual-level risk for speech disability and other developmental disabilities was also determined. The individual-level risk associated with nearly all factors was significantly greater for DD than for speech disability or other developmental disabilities. The present study suggests that information available from birth certificate records can be used to target screening and early intervention services for children at high risk with the goal of reducing the incidence of DD and subsequent associated disabilities.