{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T17:33:17Z","timestamp":1793986397990,"version":"4.8.0"},"reference-count":37,"publisher":"BMJ","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004785","name":"NordForsk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2024,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the risk of major congenital anomalies according to infection with or vaccination against covid-19 during the first trimester of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective Nordic registry based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Sweden, Denmark, and Norway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>343\u2009066 liveborn singleton infants in Sweden, Denmark, and Norway, with an estimated start of pregnancy between 1 March 2020 and 14 February 2022, identified using national health registries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Major congenital anomalies were categorised using EUROCAT (European Surveillance of Congenital Anomalies) definitions. The risk after covid-19 infection or vaccination during the first trimester was assessed by logistic regression, adjusting for maternal age, parity, education, income, country of origin, smoking, body mass index, chronic conditions, and estimated date of start of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>17\u2009704 (5.2%) infants had a major congenital anomaly. When evaluating risk associated with covid-19 infection during the first trimester, the adjusted odds ratio ranged from 0.84 (95% confidence interval 0.51 to 1.40) for eye anomalies to 1.12 (0.68 to 1.84) for oro-facial clefts. Similarly, the risk associated with covid-19 vaccination during the first trimester ranged from 0.84 (0.31 to 2.31) for nervous system anomalies to 1.69 (0.76 to 3.78) for abdominal wall defects. Estimates for 10 of 11 subgroups of anomalies were less than 1.04, indicating no notable increased risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Covid-19 infection and vaccination during the first trimester of pregnancy were not associated with risk of congenital anomalies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2024-079364","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T20:05:13Z","timestamp":1721246713000},"page":"e079364","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Covid-19 infection and vaccination during first trimester and risk of congenital anomalies: Nordic registry based study"],"prefix":"10.1136","volume":"386","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0568-3774","authenticated-orcid":false,"given":"Maria C","family":"Magnus","sequence":"first","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"S\u00f6derling","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K","family":"\u00d6rtqvist","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Obstetrics and Gynaecology, Visby County Hospital, Visby, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie Nybo","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof","family":"Stephansson","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Women's Health, Karolinska University Hospital, Solna, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri E","family":"H\u00e5berg","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"},{"name":"Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Kjaer","family":"Urhoj","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Copenhagen, Copenhagen, Denmark"},{"name":"Statistics Denmark, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"2025110102444630000_386.jul17_4.e079364.1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.22323"},{"key":"2025110102444630000_386.jul17_4.e079364.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.01.019"},{"key":"2025110102444630000_386.jul17_4.e079364.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-009495"},{"key":"2025110102444630000_386.jul17_4.e079364.4","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16969"},{"key":"2025110102444630000_386.jul17_4.e079364.5","unstructured":"UK Health Security Agency. 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