SARS-CoV-2-Infektion in der Schwangerschaft und Auftreten von angeborenen Fehlbildungen – Besteht ein Zusammenhang? Auswertung von 8032 Schwangerschaften aus dem CRONOS-Register

Zusammenfassung

Hintergrund/ Fragestellung Aufgrund einzelner Fallberichte untersuchte das COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS)-Register, gefördert durch die Deutsche Gesellschaft für Perinatalmedizin (DGPM), mit welcher Wahrscheinlichkeit eine in der Früh-Schwangerschaft aufgetretene SARS-CoV-2-Infektion der Mutter Embryopathien und/oder Fetopathien verursacht.

Material/Methode Das CRONOS-Register erfasste an über 130 beteiligten Kliniken von April 2020 bis Februar 2023 insgesamt 8032 Frauen mit nachweislicher SARS-CoV-2-Infektion in der Schwangerschaft. Sowohl mütterliche als auch kindliche Daten wurden dokumentiert und es erfolgte eine anonymisierte, deskriptive Auswertung der multizentrischen Daten.

Ergebnisse Unter 7142 vollständig dokumentierten Schwangerschaften (inklusive postnataler Daten) kam es bei 140 Feten zu einer angeborenen Fehlbildung. 8,57% der Mütter hatten eine SARS-COV-2-Infektion im 1. Trimenon und 36,43% im 2. Trimenon. 66 Fehlbildungen (47,14%) wurden erst nach der maternalen SARS-CoV-2-Infektion diagnostiziert. Es zeigte sich in der untersuchten Kohorte eine Gesamtprävalenz angeborener Fehlbildungen von 1,96%. Die im EUROCAT (European network of population-based registries for the epidemiological surveillance of congenital anomalies)-Register vor der Pandemie im Zeitraum 2017–2019 angegebene Prävalenz lag bei 2,39%.

Diskussion Die multizentrisch erhobenen Daten zeigen, dass eine mütterliche SARS-CoV-2-Infektion in der Frühschwangerschaft nicht mit einem erhöhten Fehlbildungsrisiko einhergeht.

Abstract

Background Based on single case reports, the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS) registry, sponsored by the German Society for Perinatal Medicine (DGPM), investigated the likelihood that SARS-CoV-2 infections of the mother in (early) pregnancy cause embryopathies and/or fetopathies.

Material/Methods The CRONOS registry enrolled a total of 8032 women with confirmed SARS-CoV-2 infection during pregnancy at more than 130 participating hospitals from April 2020 to February 2023. Both maternal and fetal data were documented and the anonymized multicenter data were analyzed.

Results Of 7142 fully documented pregnancies (including postnatal data), 140 showed congenital malformations. 8.57% of the mothers had had a SARS-CoV-2-infection in the 1st trimester and 36.43% in the 2nd trimester. In 66 cases with congenital malformations (47.14%), the malformation was only detected after the diagnosis of a maternal SARS-CoV-2 infection. The overall prevalence of congenital malformations in this cohort was 1.96%, compared to a prevalence of 2.39% reported in the EUROCAT (European network of population-based registries for the epidemiological surveillance of congenital anomalies) pre-pandemic registry between 2017–2019.

Discussion Our multicenter data argue against a link between maternal SARS-CoV-2 infection in early pregnancy and congenital malformation.

Schlüsselwörter

Coronavirus - COVID-19 - Fehlbildungen - Embryopathie - Fetopathie - CRONOS-Register

Key words

Coronavirus - COVID-19 - malformations - embryopathy - fetopathy - CRONOS-registry

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