Abstract：
To evaluate the risk of major congenital anomalies according to infection with or vaccination against covid-19 during the first trimester of pregnancy.
Prospective Nordic registry based study.
Sweden, Denmark, and Norway.
343 066 liveborn singleton infants in Sweden, Denmark, and Norway, with an estimated start of pregnancy between 1 March 2020 and 14 February 2022, identified using national health registries.
Major congenital anomalies were categorised using EUROCAT (European Surveillance of Congenital Anomalies) definitions. The risk after covid-19 infection or vaccination during the first trimester was assessed by logistic regression, adjusting for maternal age, parity, education, income, country of origin, smoking, body mass index, chronic conditions, and estimated date of start of pregnancy.
17 704 (5.2%) infants had a major congenital anomaly. When evaluating risk associated with covid-19 infection during the first trimester, the adjusted odds ratio ranged from 0.84 (95% confidence interval 0.51 to 1.40) for eye anomalies to 1.12 (0.68 to 1.84) for oro-facial clefts. Similarly, the risk associated with covid-19 vaccination during the first trimester ranged from 0.84 (0.31 to 2.31) for nervous system anomalies to 1.69 (0.76 to 3.78) for abdominal wall defects. Estimates for 10 of 11 subgroups of anomalies were less than 1.04, indicating no notable increased risk.
Covid-19 infection and vaccination during the first trimester of pregnancy were not associated with risk of congenital anomalies.
Prospective Nordic registry based study.
Sweden, Denmark, and Norway.
343 066 liveborn singleton infants in Sweden, Denmark, and Norway, with an estimated start of pregnancy between 1 March 2020 and 14 February 2022, identified using national health registries.
Major congenital anomalies were categorised using EUROCAT (European Surveillance of Congenital Anomalies) definitions. The risk after covid-19 infection or vaccination during the first trimester was assessed by logistic regression, adjusting for maternal age, parity, education, income, country of origin, smoking, body mass index, chronic conditions, and estimated date of start of pregnancy.
17 704 (5.2%) infants had a major congenital anomaly. When evaluating risk associated with covid-19 infection during the first trimester, the adjusted odds ratio ranged from 0.84 (95% confidence interval 0.51 to 1.40) for eye anomalies to 1.12 (0.68 to 1.84) for oro-facial clefts. Similarly, the risk associated with covid-19 vaccination during the first trimester ranged from 0.84 (0.31 to 2.31) for nervous system anomalies to 1.69 (0.76 to 3.78) for abdominal wall defects. Estimates for 10 of 11 subgroups of anomalies were less than 1.04, indicating no notable increased risk.
Covid-19 infection and vaccination during the first trimester of pregnancy were not associated with risk of congenital anomalies.
摘要：
目的：根据妊娠早期感染或接种covid-19疫苗，评估重大先天性畸形的风险。
方法：基于北欧注册的前瞻性研究。
方法：瑞典，丹麦,挪威。
方法：343066例瑞典出生的单胎婴儿，丹麦,挪威,估计在2020年3月1日至2022年2月14日之间开始怀孕，使用国家卫生登记处确定。
方法：使用EUROCAT（欧洲先天性异常监测）定义对主要先天性异常进行分类。妊娠早期covid-19感染或接种疫苗后的风险通过逻辑回归评估，调整产妇年龄，奇偶校验，教育,收入,原产国,吸烟,身体质量指数,慢性疾病,和怀孕开始的估计日期。
结果：17704例（5.2%）婴儿有严重的先天性异常。在评估妊娠早期与covid-19感染相关的风险时，调整后的比值比范围为:眼部异常的0.84(95%置信区间0.51~1.40),口面裂的1.12(0.68~1.84).同样，妊娠早期与covid-19疫苗接种相关的风险范围从神经系统异常的0.84(0.31~2.31)到腹壁缺损的1.69(0.76~3.78).11个异常亚组中有10个的估计值小于1.04，表明风险没有显着增加。
结论：妊娠早期Covid-19感染和疫苗接种与先天性异常的风险无关。
方法：基于北欧注册的前瞻性研究。
方法：瑞典，丹麦,挪威。
方法：343066例瑞典出生的单胎婴儿，丹麦,挪威,估计在2020年3月1日至2022年2月14日之间开始怀孕，使用国家卫生登记处确定。
方法：使用EUROCAT（欧洲先天性异常监测）定义对主要先天性异常进行分类。妊娠早期covid-19感染或接种疫苗后的风险通过逻辑回归评估，调整产妇年龄，奇偶校验，教育,收入,原产国,吸烟,身体质量指数,慢性疾病,和怀孕开始的估计日期。
结果：17704例（5.2%）婴儿有严重的先天性异常。在评估妊娠早期与covid-19感染相关的风险时，调整后的比值比范围为:眼部异常的0.84(95%置信区间0.51~1.40),口面裂的1.12(0.68~1.84).同样，妊娠早期与covid-19疫苗接种相关的风险范围从神经系统异常的0.84(0.31~2.31)到腹壁缺损的1.69(0.76~3.78).11个异常亚组中有10个的估计值小于1.04，表明风险没有显着增加。
结论：妊娠早期Covid-19感染和疫苗接种与先天性异常的风险无关。
