The Incidence of Congenital Malformations: A Study of 5,964 Pregnancies

Abstract

I. The plan is described of a prospective study of the outcome of 5,964 pregnancies, with special emphasis on the relationship of factors in fetal environment to the incidence of abortions, stillbirths, neonatal mortality and congenital malformations. II. Data are presented on the overall incidence of congenital malformations according to sex, race, weight at delivery, maternal age and order of birth. A. The incidence of congenital malformations among 5,739 products of conception weighing over 500 grams was 7.5%. The rate was 7.0% among infants born alive and surviving the neonatal period, 13.6% among antepartum deaths, 23.3% among intrapartum deaths, 29.6% among neonatal deaths and 70.6% among deaths occurring between the ages of one and 12 months. B. The following relationships in incidence rates among live-born infants surviving the neonatal period were found. 1. The rate among males (8.4%) was half again as high as among females (5.5%). 2. Non-white infants had a higher rate (7.8%) than white infants (6.3%). 3. Infants weighing 2,500 grams or less had a higher proportion with defects (9.7%) than did those weighing over 2,500 grams (6.7%), although this difference occurred entirely among females. 4. Maternal age had no effect on the incidence of congenital malformations. 5. White infants of lower birth order had a lower rate (5.3%) than did those of higher birth orders (8.2%). No difference according to birth order was observed among non-white infants. III. A system of classification of malformations is described and discussed. Incidence rates by organ system groups are presented. A. Less than one-half of the malformations found among live-born infants were suspected or noted at birth. B. Malformations of musculo-skeletal system and skin were more frequent than malformations of other systems. Incidence rates by organ system groups are directly related to problems of diagnosis. C. Of the malformed live-born infants, 14.8% had more than one malformation and in 9.1% more than one system was involved. Of the malformed stillbirths and neonatal deaths, 66.0% had more than one malformation and in 51.1% more than one system was involved.

Maternal, fetal and neonatal outcomes among pregnant women receiving COVID-19 vaccination: The preg-co-vax study

“…The EUROCAT reported that each year in the European Union, approximately 125,000 fetuses and infants of 5.0 million births (2.5%) have a congenital anomaly ( 37 ). Another study reported that the incidence of congenital malformations among 5,739 products of conception (weighing over 500 g) was 7.5%; the rate was 7.0% among infants born alive and surviving the neonatal period, 13.6% among antepartum deaths, 23.3% among intrapartum deaths, and 29.6% among neonatal deaths ( 38 ).…”

Problems of Ascertainment of Congenital Anomalies

“…However, once contact is made, the detection or recording of an anomaly does not automatically follow. For example, in a study in which physical examinations were performed at birth, 6 months, and 12 months, Mcintosh et al [11] found that of all 465 affected births eventually identified in their series, only 201 (43.2%) 'presented signs, symptoms and RG (roentgenographic) abnormalities which were observable at birth'.…”

“…There is a range of possibilities for dealing with the problems of ascertainment and, in particular, underascertainment. One method is population screening, but follow-up studies have shown that cases are missed by this approach [6,11 ].…”

Prevención primaria de los defectos congénitos

“…Mediante programas de vacunación se ha tenido mucho éxito en la eliminación de esta enfermedad. Al año de edad, se coloca la vacuna trivalente: sarampión, rubéola y parotiditis y un refuerzo entre los 6 a 12 años 3,[13][14][15] . A las niñas adolescentes, no vacunadas y que no tienen antecedentes de haber tenido la enfermedad, se les coloca la vacuna monovalente antirubéola.…”

“…Para su prevención, es importante difundir las medidas de higiene, para evitar el contagio de las embarazadas. Durante los controles médicos prenatales, realizar estudios seriados, con serología para el toxoplasma, en las mujeres en riesgo, efectuando tratamiento preventivo si hay seroconversión [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]18 .…”