Congenital microcephaly in Quebec: baseline prevalence, risk factors and outcomes in a large cohort of neonates
| Autor: | Laura Arbour, Jessica Healy-Profitós, Anne-Marie Lowe, Caroline Quach, Nathalie Auger |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Microcephaly Rubella Congenital Abnormalities 03 medical and health sciences 0302 clinical medicine Pregnancy Residence Characteristics Risk Factors 030225 pediatrics Epidemiology medicine Diabetes Mellitus Prevalence Humans 030212 general & internal medicine Risk factor Pregnancy Complications Infectious Retrospective Studies business.industry Infant Newborn Quebec Obstetrics and Gynecology Retrospective cohort study General Medicine medicine.disease Teratology Infant mortality 3. Good health Socioeconomic Factors Maternal Exposure Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Archives of disease in childhood. Fetal and neonatal edition. 103(2) |
| ISSN: | 1468-2052 |
| Popis: | ObjectiveWe assessed baseline prevalence, risk factors and outcomes of microcephaly in a large population of neonates.DesignRetrospective cohort study.SettingAll hospitals in the province of Quebec, Canada.Participants794 microcephalic and 1 944 010 non-microcephalic infants born between 1989 and 2012.Main outcome measuresBaseline prevalence of microcephaly and occurrence of other congenital anomalies. We estimated the association of (1) pregnancy risk factors including TORCH infections (toxoplasmosis, rubella, cytomegalovirus, herpes, other), exposure to teratogens, diabetes and maternal congenital anomalies with risk of microcephaly, and (2) microcephaly with risk of infant mortality and severe morbidity, adjusted for maternal characteristics.ResultsThe overall prevalence of microcephaly was 4.1 per 10 000, ranging between 3.0 and 5.3 per 10 000 over time. Only 37% of microcephalic infants presented with other congenital anomalies. Maternal infection during pregnancy was the strongest risk factor, with 32 times the risk of microcephaly (prevalence ratio 32.38; 95% CI 22.42 to 46.75) compared with no infection. Exposure to teratogens was the next most important risk factor, with three times greater risk (prevalence ratio 3.10; 95% CI 2.37 to 4.07). Microcephaly was associated with 20 times the risk of infant mortality compared with no microcephaly (prevalence ratio 20.52; 95% CI 15.57 to 27.04) and significantly greater infant morbidity.ConclusionsIn Canada, infectious exposure during pregnancy is a strong risk factor for microcephaly, and affected infants are at higher risk of poor birth outcomes. Better monitoring of microcephaly is needed in the event that Zika or other novel viruses affect future risk. |
| Databáze: | OpenAIRE |
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