A new study conducted by researchers at St. George’s, University of London, has revealed a significant 16% rise in the proportion of babies born with congenital heart abnormalities after the first year of the COVID-19 pandemic. The research, published in Ultrasound in Obstetrics and Gynecology, highlights concerning trends that suggest potential long-term effects of the pandemic on maternal and fetal health.
Congenital heart abnormalities are the most common form of birth defect, impacting the structure and function of the heart. Globally, they affect approximately 1 in 110 births, with 13 babies in the UK diagnosed every day. These conditions range from defects in the heart’s valves to issues with the major blood vessels surrounding the heart or the formation of holes in the heart.
To understand the effects of the pandemic on these heart defects, the researchers undertook a detailed analysis of data from more than 18 million births. The data was sourced from the Centers for Disease Control and Prevention (CDC) in the United States and spanned a period from December 2016 to November 2022. By comparing pre-pandemic data with data collected during the pandemic, the researchers aimed to evaluate whether the disruptions caused by COVID-19 had a measurable impact on fetal health.
The Scope and Methodology of the Study
The study compared the number of babies born with congenital heart defects during two distinct periods: December 1, 2016, to November 30, 2019 (pre-pandemic), and December 1, 2020, to November 30, 2022 (pandemic period). Notably, the first year of the pandemic, from December 2019 to November 2020, was excluded to allow for the delayed impacts of the virus and associated societal disruptions to be accounted for.
The researchers analyzed 11,010,764 births from the pre-pandemic period and 7,060,626 births during the pandemic. Importantly, they adjusted their findings to consider a variety of maternal factors that could influence the likelihood of congenital heart defects. These included the mother’s body mass index (BMI), diabetes status, blood pressure before pregnancy, age, number of previous births, and the season in which prenatal care began.
To ensure the observed trends were specific to congenital heart abnormalities and not indicative of broader issues in prenatal care, the researchers also examined rates of Down syndrome births over the same period. As a genetic condition, Down syndrome is not influenced by external factors such as infections or healthcare disruptions.
Key Findings: A 16% Surge in Heart Defects
The study revealed a stark 16% increase in the rate of congenital heart abnormalities after the pandemic’s first year. Specifically, cases rose from 56.5 per 100,000 live births during the pre-pandemic period to 65.4 per 100,000 live births in the pandemic period.
In contrast, the rate of babies born with Down syndrome remained stable throughout the study period. This consistency strengthened the researchers’ conclusion that the rise in congenital heart abnormalities was unlikely to be due to reduced access to antenatal care or disruptions in health services, both of which could disproportionately affect diagnoses of conditions requiring ongoing monitoring.
Implications and Possible Causes
The findings raise important questions about the potential causes of this increase. While the study did not identify a specific mechanism, several possibilities warrant further investigation.
One hypothesis is that maternal exposure to COVID-19 during pregnancy may have directly influenced fetal development. Previous research has suggested that certain viral infections can have teratogenic effects, meaning they can interfere with normal fetal development. The SARS-CoV-2 virus, which causes COVID-19, may have similar impacts, particularly during critical periods of cardiac formation in early pregnancy.
Another possibility is that the stress and societal disruptions caused by the pandemic indirectly affected maternal and fetal health. High levels of maternal stress have been linked to increased risks of certain congenital conditions. Additionally, changes in healthcare access and maternal behaviors during the pandemic, such as delayed prenatal visits or reduced physical activity, could have played a role.
The researchers also noted the need to explore whether socioeconomic factors exacerbated by the pandemic, such as financial instability and food insecurity, contributed to the observed trends. These factors have long been associated with adverse pregnancy outcomes and may have been heightened during the pandemic’s peak.
Importance of Continued Research and Monitoring
The study’s findings underscore the need for ongoing research to fully understand the pandemic’s impact on maternal and child health. As the effects of COVID-19 continue to unfold, it is critical to identify vulnerable populations and implement targeted interventions to mitigate long-term consequences.
Healthcare providers may need to enhance prenatal screening and monitoring programs to identify congenital heart abnormalities earlier. This could help ensure timely interventions, potentially improving outcomes for affected infants.
Furthermore, the findings highlight the broader importance of maintaining robust healthcare systems even during global crises. Ensuring consistent access to antenatal care and minimizing stressors for pregnant individuals could be key to preventing similar outcomes in the future.
