TABLE 3.
Birth defects reported among liveborn infants born to people with SARS‐CoV‐2 infection in pregnancy, by trimester of infection and in comparison, with prevalence estimates from published literature, when available, SET‐NET, 15 Jurisdictions, January 25, 2020–December 31, 2020 (unweighted N = 22,372)
| Trimester of infection a unweighted n (weighted prevalence per 10,000 live births [95% CI]) | Prevalence per 10,000 live births in literature | |||||
|---|---|---|---|---|---|---|
| Total unweighted n b | Total prevalence per 10,000 live births c weighted prevalence (95% CI) | First n = 3,119 | Second n = 5,696 | Third n = 10,651 | ||
| Total | 825 | 553.4 (510.3–596.5) |
88 (434.5 [325.4–543.7]) |
258 (623.0 [531.7–714.3]) |
479 (550.0 [496.3–603.7]) |
— |
| Central nervous system | 31 | 20.9 (11.9–30.0) |
3 (25.8 [0–56.6]) |
14 (27.1 [9.9–44.3]) |
14 (15.8 [5.8–25.9]) |
— |
| Eye | 4 | 2.1 (0–4.3) | 0 | 1 |
3 (3.2 [0–7.1]) |
— |
| Ear | 40 | 26.5 (16.6–36.3) |
6 (30.9 [0.1–61.7]) |
9 [16.4 (5.1–27.8)] |
25 (31.1 [16.4–45.8]) |
— |
| Cardiovascular | 240 | 136.3 (115.6–157.0) |
29 (100.9 [57.2–144.5]) |
93 (191.4 [142.8–239.9]) |
118 (115.3 [91.8–138.7]) |
— |
| Critical congenital heart disease (CCHD) d , e | 26 | 13.5 (7.4–19.6) |
5 (12.8 [1.6–24.1]) |
8 (16.3 [1.5–31.1]) |
13 (12.1 [5.2–19.0]) |
15.6 (95% CI 10.8–15.3) (Reller, Strickland, Riehle‐Colarusso, Mahle, & Correa, 2008) |
| Atrial septal defect | 109 | 58.3 (45.5–71.2) |
10 (43.8 [10.3–77.3]) |
41 (64.5 [42.1–86.9]) |
58 (59.3 [41.7–77.0]) |
64.7 (95% CI 0.0–171.7) (Mai et al., 2015) |
| Pulmonary valve atresia and stenosis | 7 | 3.4 (0.8–6.1) | 0 |
5 (6.9 [0.9–12.9]) |
2 |
9.65 (95% CI 9.38, 9.92) (Mai, Isenburg, Canfield, et al., 2019) |
| Tetralogy of fallot | 6 | 4.2 (0–8.6) | 1 | 1 |
4 (3.2 [0.1–6.4]) |
4.60 (95% CI 4.42, 4.79) (Mai et al., 2019) |
| Ventricular septal defect | 74 | 43.1 (30.8–55.3) |
10 (35.5 [7.0–63.9]) |
23 (49.7 [23.8–75.6]) |
41 (41.6 [26.3–56.8]) |
43.4 (95% CI 10.1–76.6) (Mai et al., 2015) |
| Orofacial | 25 | 15.0 (7.8–22.3) |
4 (12.8 [0–26.2]) |
5 (12.1 [0–26.2]) |
16 (17.5 [7.1–27.8]) |
— |
| Cleft lip with or without cleft palate | 21 | 11.7 (5.8–17.6) |
3 (10.3 [0–22.6]) |
4 (5.5 [0.1–10.9]) |
14 (15.8 [5.8–25.9]) |
10.25 (95% CI 9.97, 10.54) (Mai et al., 2019) |
| Gastrointestinal | 92 | 60.0 (45.7–74.5) |
6 (20.5 [3.1–38.0]) |
31 (76.9 [43.2–110.7]) |
55 (62.7 [44.5–80.7]) |
— |
| Genitourinary | 156 | 86.1 (70.9–101.3) |
16 (58.6 [24.2–93.0]) |
41 (73.7 [46.8–100.5]) |
99 (102.0 [80.3–123.8]) |
|
| Hypospadius f | 29 | 25.9 (16.2–35.5) |
5 (25.6 [3.2–48.1]) |
5 (16.3 [1.3–31.4]) |
19 (31.4 [17.0–45.8]) |
64.7 (95% CI 23.0–106.3) (Mai et al., 2015) |
| Musculoskeletal | 117 | 70.6 (55.1–86.2) |
13 (58.7 [17.7–99.6]) |
39 (93.3 [56.3–130.3]) |
65 (61.2 [45.6–76.7]) |
— |
| Gastroschisis | 4 | 1.7 (0–3.4) | 1 | 1 | 2 | 5.39 (95% CI 5.19, 5.59) (Mai et al., 2019) |
| Polydactyly | 20 | 13.3 (6.2–20.5) | 2 |
7 (21.1 [1.8–40.5]) |
11 (11.3 [4.2–18.4]) |
14.22 g (Kucik, Alverson, Gilboa, & Correa, 2012) |
| Talipes equinovarus (clubfoot) | 27 | 15.1 (8.0–22.3) | 1 |
10 (24.3 [4.4–44.1]) |
16 (13.7 [6.8–20.5]) |
17.07 (95% CI 16.67, 17.48) (Mai et al., 2019) |
| Chromosomal | 24 | 15.3 (7.6–23.1) |
5 (34.1 [0–68.2]) |
7 (14.9 [0.3–29.4]) |
12 (9.7 [4.2–15.1]) |
— |
| Trisomy 21 | 16 | 10.3 (4.0–16.6) |
4 (31.5 [0–65.3]) |
2 |
10 (8.0 [3.1–13.0]) |
14.85 (95% CI 14.52, 15.19) (Mai et al., 2019) |
Trimester of SARS‐CoV‐2 infection is based on calculated date of last menstrual period and date of first positive COVID‐19 laboratory result.
Fifteen jurisdictions with sufficient data linkages to birth defects surveillance or medical record abstraction for determining presence or absence and type of birth defects are Arkansas, City of Chicago, City of Houston, Iowa, Illinois (excluding Chicago), Minnesota, Missouri, Nebraska, New Jersey, New York (excluding New York City), Pennsylvania, Philadelphia, Puerto Rico, South Carolina, and Washington.
Prevalence was calculated when total unweighted case count for a defect was ≥3.
Subcategories may not add to total for the system level categories because there may be additional infrequent defects not individually described.
CCHD included single ventricle, tricuspid atresia, Ebstein anomaly, hypoplastic left heart, hypoplastic right heart, common truncus, transposition, atrioventricular septal defects, tetralogy of Fallot, aortic valve atresia/stenosis, coarctation, total anomalous pulmonary venous return, anomalous coronary artery.
Denominator for calculation of prevalence included only male infants.
Metropolitan Atlanta Congenital Defects Program (MACDP) does not report 95% confidence intervals.