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Infant morbidity following amniocentesis and chorionic villus sampling for prenatal karyotyping
Maria Cederholm1, Bengt Haglund, Ove Axelsson
1Department of Women's and Children's Health, Section of Obstetrics and Gynaecology, Uppsala University, SE-751 85 Uppsala, Sweden.
Insights
Amniocentesis before 14 weeks increases risks of infant postural deformities. Later amniocentesis (14-15 weeks) is linked to respiratory issues. Chorionic villus sampling showed no increased risks in this study.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Fetal Medicine
Background:
- Prenatal diagnostic procedures like amniocentesis and chorionic villus sampling are common in high-risk pregnancies.
- Understanding potential risks associated with these procedures is crucial for informed decision-making.
Purpose of the Study:
- To evaluate the association between amniocentesis and chorionic villus sampling and adverse infant outcomes.
- To determine the impact of gestational age at the time of these procedures on potential risks.
Main Methods:
- A population-based cohort study was conducted in Sweden between 1991 and 1996.
- Data from 71,586 women aged 35-49 with single births were analyzed, comparing exposed (amniocentesis or CVS) and non-exposed groups.
- Infant outcomes were extracted from national health registers, and logistic regression was used to calculate odds ratios.
Main Results:
- Amniocentesis before 14 weeks gestation was associated with an increased risk of musculoskeletal deformities (OR=1.32).
- Respiratory disturbances were more frequent in the amniocentesis group, particularly when performed at 14-15 weeks gestation (OR=1.12).
- No significant risks were found for limb reduction defects, mortality, prematurity, low birthweight, or fetal distress in either procedure group.
Conclusions:
- Amniocentesis before 14 weeks gestation is linked to a higher risk of postural deformities in newborns.
- Amniocentesis performed at 14-15 weeks gestation is associated with increased respiratory problems.
- Further research with larger cohorts is needed to definitively assess risks associated with chorionic villus sampling.
Objective:
To investigate whether amniocentesis and chorionic villus sampling increase the risk of postural deformities, limb reduction defects, respiratory problems in the newborn, fetal and infant mortality, prematurity, low birthweight and fetal distress, and to investigate the impact of gestational length at the time of the procedure.
Design:
A population-based cohort study.
Setting:
Sweden, 1991-1996.
Population:
All women, 35 to 49 years old, with single births (n= 71,586). The women were classified as exposed to amniocentesis (n= 21,748) or chorionic villus sampling (n= 1984) or not exposed (n= 47,854).
Methods:
Infant outcomes were collected from the Swedish Medical Birth Register, the Swedish Hospital Discharge Register, the Swedish Malformation Register and the Swedish Cause of Death Register. Odds ratios were calculated with logistic regression analyses.
Main Outcome Measures:
Crude and adjusted odds ratios of postural deformities, limb reduction defects, respiratory problems in the newborn, fetal and infant mortality, prematurity, low birthweight and fetal distress. Women exposed to amniocentesis or chorionic villus sampling were compared with non-exposed women.
Results:
An increased risk of musculoskeletal deformities (OR = 1.32, 95% CI 1.11-1.57) including club foot and hip dislocation was found in the amniocentesis group, especially for amniocentesis prior to 14 weeks of gestation. Respiratory disturbances such as neonatal pneumonia, meconium aspiration, atelectasis and tachypnea were found more often in the amniocentesis group (OR = 1.12, 95% CI 1.02-1.24), with the greatest risk at 14 and 15 weeks of gestation. For the chorionic villus sampling group, no significant associations were found. No increase regarding limb reduction defects, fetal and infant mortality, prematurity, low birthweight and fetal distress was found in either the amniocentesis or the chorionic villus sampling group.
Conclusions:
Among women aged 35-49 years, amniocentesis before 14 weeks of gestation increases the risk of postural deformities. Amniocentesis at 14 and 15 weeks increases the risk of respiratory disturbances. For chorionic villus sampling, a larger study group is needed before such risks can be ruled out.
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