Malformations reported in chorionic villus sampling exposed children: A review and analytic synthesis of the literature

Purpose: To determine whether the frequency of vascular disruption defects, other than limb defects, is increased in reports of chorionic villus sampl ing (CVS) exposed children compared with an unexposed population. Methods: Only studies that reported the total number of CVS-exposed pregnancies and details of pregnancy outcome, including all the malformations, were include d. Twenty-five articles met these criteria. Results: The frequencies of gas troschisis, intestinal atresias, and clubfoot were significantly increased among the CVS-exposed infants as compared with the baseline unexposed popul ation. The frequencies of other vascular disruption defects, including Pola nd sequence, amniotic band sequence, and cleft lip/cleft palate, were not i ncreased. Conclusion: CVS-exposed children have an increased frequency of i ntestinal atresia, gastroschisis, and clubfoot compared with the nonexposed population. The fact that an increased frequency of other defects attribut ed to vascular disruption was not found may be due to under-ascertainment, misclassification, or "lumping" of the defects identified in previous studi es.