{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T11:09:01Z","timestamp":1782040141681,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In observational medication pregnancy safety studies, children are often followed from birth to 1\u2009year of age. However, some major congenital malformations (MCM) may take longer to diagnose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to investigate the proportion of children with detected MCMs at different lengths of follow\u2010up and compare them to the proportion detected at 1\u2009year after birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based register study included all singleton children liveborn in Sweden from 2006 to 2016. MCM were identified by ICD\u201010 codes in the Medical Birth Register and National Patient Register, aligned to the EUROCAT classification system. Cumulative proportion of children with detected MCM at birth, 90\u2009days, 1, 2, and 3\u2009years was calculated and compared between children born preterm and at term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 1,138,113 liveborn children, the cumulative proportion of children with a detected MCM increased from 1.9% at birth to 3.1%, 3.9%, 4.4% and 4.7% at 90\u2009days, 1, 2, and 3\u2009years after birth, respectively, and varied by MCM subgroup. MCMs of the eye, ear\u2010face\u2010neck, nervous system and genitals were detected with the longest delay, with 31%\u201359% more detected at 3\u2010 versus 1\u2010year follow\u2010up. Compared to children born at term, the proportion of children with any MCM was 2.5 times higher amongst preterm children, with a higher proportion detected over the first 90\u2009days for most MCM subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proportion of children with a detected MCM varied by MCM subgroup and follow\u2010up time. In pharmacoepidemiology studies of medication safety in pregnancy using Swedish national data, the length of child follow\u2010up should be chosen in accordance with the expected age at detection\u00a0if a specific subgroup of MCM is under investigation, for example, eye and genital MCM require longer follow\u2010up for detection than abdominal wall and digestive system MCM. However, in most circumstances, 1\u2009year of follow\u2010up is sufficient.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13011","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T05:09:35Z","timestamp":1697087375000},"page":"521-531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Detection of major congenital malformations depends on length of <scp>follow\u2010up<\/scp> in Swedish National Health Register Data: Implications for pharmacoepidemiological research on medication safety in pregnancy"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0210-5829","authenticated-orcid":false,"given":"Silvia","family":"Segovia\u00a0Chac\u00f3n","sequence":"first","affiliation":[{"name":"Centre for Pharmacoepidemiology, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-1713","authenticated-orcid":false,"given":"P\u00e4r","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5759-9366","authenticated-orcid":false,"given":"Carolyn E.","family":"Cesta","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311845"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-90-481-9485-8_20"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20776"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.22887"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-7843.2009.00494.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2515\/therapie\/2014009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1798"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2638"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.9840"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.4109"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26561"},{"key":"e_1_2_10_13_1","volume-title":"Birth defects surveillance: a manual for programme managers","author":"World Health Organization","year":"2020"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paed.2018.10.002"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12581019"},{"key":"e_1_2_10_16_1","first-page":"1480","article-title":"Imaging of congenital malformations","volume":"22","author":"McVige JW","year":"2016","journal-title":"Continuum (Minneap Minn)"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2022.07.012"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23534"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20658"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0348-y"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2013.07.009"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-016-0117-y"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-022-00947-5"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0316-1"},{"key":"e_1_2_10_25_1","volume-title":"EUROCAT Guide 1.4: Instruction for the registration of congenital anomalies","author":"EUROCAT (European Surveillance of Congenital Anomalies)","year":"2013"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-023-00971-z"},{"key":"e_1_2_10_27_1","unstructured":"EUROCAT (European Surveillance of Congenital Anomalies).Prevalence charts and tables.2022Accessed November 21 2022. 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