Maternal genitourinary infections and risk of birth defects in the National Birth Defects Prevention Study

Birth Defects Res. 2018 Nov 15;110(19):1443-1454. doi: 10.1002/bdr2.1409. Epub 2018 Nov 6.


Background: Genitourinary infections (GUIs) are common among sexually active women. Yet, little is known about the risk of birth defects associated with GUIs.

Methods: Using data from the National Birth Defects Prevention Study, a multisite, population-based, case-control study, we assessed self-reported maternal GUIs in the month before through the third month of pregnancy (periconception) from 29,316 birth defect cases and 11,545 unaffected controls. We calculated odds ratios (ORs) and 95% confidence intervals to estimate the risk of 52 major structural birth defects associated with GUIs. We also calculated risk of birth defects associated with each type of GUI: urinary tract infection (UTI) and sexually transmitted infection (STI).

Results: In our analysis, 10% (n = 2,972) of case and 9% (n = 1,014) of control mothers reported a periconceptional GUI. A GUI was significantly associated with 11 of the 52 birth defects examined (ORs ranging from 1.19 to 2.26): encephalocele, cataracts, cleft lip, esophageal atresia, duodenal atresia/stenosis, small intestinal atresia/stenosis, colonic atresia/stenosis, transverse limb deficiency, conoventricular septal defect, atrioventricular septal defect, and secundum atrial septal defect. A periconceptional UTI was significantly associated with nine birth defects (ORs from 1.21 to 2.48), and periconceptional STI was significantly associated with four birth defects (ORs ranging from 1.63 to 3.72).

Conclusions: While misclassification of GUIs in our analysis is likely, our findings suggest GUIs during the periconceptional period may increase the risk for specific birth defects.

Keywords: birth defects; congenital malformations; genitourinary infections; infections; sexually transmitted infections; urinary tract infection.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Case-Control Studies
  • Congenital Abnormalities / classification
  • Congenital Abnormalities / epidemiology*
  • Female
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Logistic Models
  • Male
  • Mothers
  • Odds Ratio
  • Population Surveillance / methods*
  • Pregnancy
  • Pregnancy Trimester, First
  • Prenatal Exposure Delayed Effects / chemically induced
  • Reproductive Tract Infections / complications
  • Reproductive Tract Infections / physiopathology
  • Risk Factors
  • Self Report
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / physiopathology