Congenital anomalies during Covid-19: artifact of surveillance or a real TORCH?

IF 7.7 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Nathalie Auger, Laura Arbour, Antoine Lewin, Émilie Brousseau, Jessica Healy-Profitós, Thuy Mai Luu
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引用次数: 0

Abstract

Infections in the first trimester of pregnancy can be teratogenic, but the possibility that Covid-19 could lead to birth defects is unclear. We examined whether SARS-CoV-2 infection during pregnancy or exposure to pandemic conditions were associated with the risk of congenital anomalies. We carried out a retrospective study of 420,222 neonates born in Quebec, Canada in two time periods: prepandemic (January 1, 2017 to March 12, 2020) vs. pandemic (March 13, 2020 to March 31, 2022). We classified pandemic births as early (first trimester completed before the pandemic) or late (first trimester during the pandemic), and identified patients with SARS-CoV-2 infections during pregnancy. We applied (1) adjusted log-binomial regression models to assess the association between SARS-CoV-2 infection and congenital anomalies, and (2) autoregressive interrupted time series regression to analyze temporal trends in the monthly number of defects in all patients regardless of infection. In total, 29,263 newborns (7.0%) had a congenital anomaly. First trimester SARS-CoV-2 infections were not associated with a greater risk of birth defects compared with no infection (RR 1.07, 95% CI 0.59–1.95). However, births during the late pandemic period were more likely to be diagnosed with congenital microcephaly compared with prepandemic births (RR 1.44, 95% CI 1.21–1.71). Interrupted time series analysis confirmed that the frequency of microcephaly increased during the late pandemic period, whereas other anomalies did not. We conclude that Covid-19 is likely not teratogenic, but enhanced surveillance of anomalies among late pandemic births may have heightened the detection of infants with microcephaly.

Abstract Image

Covid-19 期间的先天性畸形:监视的假象还是真正的 TORCH?
妊娠头三个月的感染可能会致畸,但Covid-19导致出生缺陷的可能性尚不清楚。我们研究了孕期感染 SARS-CoV-2 或接触大流行病是否与先天性畸形的风险有关。我们对加拿大魁北克省出生的 420,222 名新生儿进行了回顾性研究,研究分为两个时间段:大流行前(2017 年 1 月 1 日至 2020 年 3 月 12 日)与大流行期间(2020 年 3 月 13 日至 2022 年 3 月 31 日)。我们将大流行期间的新生儿分为早期(大流行前三个月)和晚期(大流行期间的前三个月),并确定了孕期感染 SARS-CoV-2 的患者。我们采用(1)调整对数二项式回归模型来评估 SARS-CoV-2 感染与先天性畸形之间的关联,以及(2)自回归间断时间序列回归来分析所有患者(无论感染与否)每月缺陷数量的时间趋势。共有 29,263 名新生儿(7.0%)患有先天性畸形。与未感染相比,头三个月感染 SARS-CoV-2 与出生缺陷的更大风险无关(RR 1.07,95% CI 0.59-1.95)。然而,与大流行前的新生儿相比,大流行后期的新生儿更有可能被诊断为先天性小头畸形(RR 1.44,95% CI 1.21-1.71)。间断时间序列分析证实,在大流行后期,小头畸形的发病率有所上升,而其他畸形的发病率则没有上升。我们的结论是,Covid-19 很可能不会致畸,但加强对大流行后期出生婴儿异常情况的监测可能会提高小头畸形婴儿的检出率。
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来源期刊
European Journal of Epidemiology
European Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
21.40
自引率
1.50%
发文量
109
审稿时长
6-12 weeks
期刊介绍: The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.
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