Large population-based assessment of SARS-CoV-2 teratogenicity by profiling congenital anomalies during COVID-19...

This study examined population-level trends in congenital anomalies before and during the coronavirus disease-19 (COVID-19) pandemic in India, which experienced one of the most severe COVID-19 outbreaks with multiple devastating waves.

We conducted a retrospective analysis of prospectively collected data from the Antenatal Detection of Congenital Anomalies registry between pre-pandemic (January 2018-May 2020) and pandemic (June 2020-December 2022). Time series analysis examined temporal trends and seasonal patterns.

Among 175,749 prenatal scans, 2.895 congenital anomalies were detected (overall rate 16.5 per 1,000 scans). Detection rates were similar pre-pandemic (14.8 per 1,000 scans, n=1.370) and during the pandemic (18.3 per 1.000 scans, n=1.525; p=0.096). The distribution of anomalies by organ system remained consistent, with head/neck and genitourinary anomalies predominating (19-23% and 14-22% annually, respectively). A persistent seasonal pattern was observed, with peaks in the fourth quarter annually (mean November: 62.7 cases) and troughs at the beginning of each year (mean January: 36.8 cases). The Seasonal Autoregressive Integrated Moving Average model accurately predicted 2023 trends confirming the stability of the epidemiologic process.

Our large-scale study provides compelling evidence that the COVID-19 pandemic was not associated with a change in the rate or pattern of congenital anomalies at the population level. The discovery of a robust seasonal variation in anomaly detection represents a significant finding that demands detailed delineation to inform preventive strategies.