title: A structurally normal fetus at the 11- to 14-week ultrasound does not guarantee a newborn without congenital anomalies: a cohort study.
abstract: OBJECTIVE
  The objective of this study was to analyze the influence of maternal demographic characteristics and abnormal first-trimester sonographic markers on congenital anomalies (CAs) at birth when the fetus is structurally normal at the 11- to 14-week ultrasound.
  
  
  METHODS
  This prospective cohort study comprised high-risk women undergoing routine antenatal care. Detailed assessments of fetal anatomy and first-trimester sonographic markers were performed at 11-14 weeks of pregnancy. Multilevel regression analysis was used to determine the effects of maternal characteristics and abnormal first-trimester sonographic markers on the incidence of CA at birth.
  
  
  RESULTS
  Three hundred and ten patients were evaluated, and 41 patients (13.2%) had an anomalous newborn. The presence of a specific indication at the first-trimester ultrasound (OR: 2.72; CI 95% 1.09-6.74) or a nuchal translucency (NT) thickness greater than 2.5 mm increased the risk of CA at birth by three fold (OR: 3.10; CI 95% 1.07-9.59). High adjusted risks for trisomies 21, 18 and 13 increased the likelihood of having a structurally abnormal newborn by five, twelve and six fold, respectively.
  
  
  CONCLUSIONS
  Increased NT and/or high adjusted risks for trisomies 21, 18, and 13 increase the risk of CA at birth, even in fetuses with a structurally normal 11- to 14-week ultrasound scan.
authors: a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
authors: Angelo
authors: A
authors: Mario Sarti
authors: a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
authors: Marcos Masaru
authors: MM
authors: Okido
authors: b Department of Obstetrics , Paulista School of Medicine - Federal University of São Paulo , São Paulo , Brazil.
authors: Edward
authors: E
authors: Araujo Júnior
authors: a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
authors: Ricardo de Carvalho
authors: Rde C
authors: Cavalli
authors: a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
authors: Silvana Maria
authors: SM
authors: Quintana
authors: a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
authors: Geraldo
authors: G
authors: Duarte
authors: a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
authors: Alessandra Cristina
authors: AC
authors: Marcolin
mesh_terms: D001938:Brazil; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging*; D005260:Female; D005333:Fetus / Q000033:anatomy & histology*; D006801:Humans; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D016216:Ultrasonography, Prenatal
keywords: Adjusted risk; congenital anomaly; first-trimester screening; nuchal translucency; trisomy