What is the difference between congenital in origin and acquired

Conium maculatum poison hemlock causes contracture defects and occasionally cleft palate in cattle, goats, sheep, and pigs. Both the plant and seed contain the teratogenic alkaloidal toxin coniine. Ingestion of Nicotiana tabacum cultivated tobacco produces skeletal defects in pigs similar to those induced in cattle and pigs by Lupinus spp and C maculatum.

Congenital amelia and hemimelia in piglets that occurred when pregnant sows were allowed access to tobacco stalks are seldom seen today due to changes in swine management. Nicotiana glauca tree tobacco also induces contracture defects and cleft palate in cattle, sheep, and goats. Other plants suspected of causing similar defects in calves include Senecio spp, Cycadales , Blighia , Papaveraceae , Colchicum , Vinca spp, and Indigofera spicata and related plants.

Sudan grass Sorghum vulgare has been incriminated as a cause of congenital joint contracture in horses, and S sudanense may cause arthrogryposis in calves. Pregnant mares consuming fescue pasture or fescue hay infected with the fungal endophyte Fescue Poisoning Fescue lameness, which resembles ergot poisoning, is believed to be caused by ergot alkaloids, especially ergovaline, produced by the endophyte fungus Neotyphodium coenophialum in tall fescue Ergovaline and other ergot alkaloids produced by the endophyte are the cause of fescue toxicosis.

Endophyte-free fescue and fescue infected by nontoxic strains of endophyte reportedly can be grazed safely by pregnant mares. Congenital hypothyroidism in foals has been linked to increases of dietary nitrate concentrations in pregnant mares in western Canada and to dietary exposure of late gestation mares to N coenophialum —infected fescue.

Pesticides, herbicides, pharmaceutical agents, and other chemicals have been incriminated as teratogenic agents. Currently, drugs and chemicals undergoing approval processes in the USA, Canada, and many other countries must be tested for teratogenic potential before commercial licensing. Products may be labeled with instructions to specifically avoid use in animals that are pregnant or may be pregnant.

Other products may be labeled as safe for pregnant animals once the fetus exceeds a specified gestational age.

When using some herbicides, it may be necessary to withhold animals from pasture for specified periods after application. Extralabel use of pharmaceutical agents in pregnant animals and inadvertent exposure to pesticides and other chemicals carries inherent risks, including adverse effects on the developing fetus. Practitioners and producers should be aware of the potential for pregnancy loss or development of congenital anomalies after administration of therapeutic agents or exposure to pesticides and chemicals and should exercise appropriate caution when using such products.

Prenatal viral infections may be teratogenic in cattle, sheep, goats, pigs, dogs, and cats but have rarely been incriminated in congenital defects in horses. The stage of fetal or embryonic development at the time of exposure determines the type and extent of the anomalies observed. Viral infection in late gestation may result in fetal infection and seroconversion without observed clinical signs, while exposure during earlier stages may induce pregnancy loss or induce congenital defects.

Production of neonates with congenital anomalies after in utero infection may follow observable clinical disease in the dam; however, anomalies are also seen without history of disease during pregnancy.

On occasion, use of modified-live virus vaccines in pregnant animals has produced congenital defects; such use is discouraged. Pestivirus infections are teratogenic in many species. Infection leads to immunosuppression and can cause signs in multiple body systems in addition to Immunotolerant, persistently infected animals may result from fetal infection with noncytopathic BVDV before gestational day These animals serve as a major reservoir of infection.

Pestivirus infections in other species also result in congenital defects. Infection of pregnant ewes with border disease Border Disease Border disease is observed in young ruminants exposed to border disease virus during gestation.

Surviving lambs demonstrate failure to thrive, a long hair coat, and tremors, giving rise to the Defects include tremors, ataxia, abnormal hair coat, low birth weight, facial and ocular abnormalities, depressed immune response, and birth of small, weak lambs with poor growth and viability.

Infection of pregnant ewes with BVDV from cattle has produced identical congenital anomalies in sheep. Infected pigs develop fever, hemorrhages, lethargy, yellowish diarrhea, vomiting, and a purple skin The virus has been eradicated in the USA but remains a major cause of swine disease in some areas.

Prenatal infection can result in congenital defects similar to those seen in cattle infected with BVDV. Cache Valley virus infection of pregnant ewes may result in anomalies in their lambs, including arthrogryposis, torticollis, scoliosis, lordosis, hydranencephaly, microcephaly, porencephaly, and cerebellar and muscular hypoplasia.

Other ruminant species may be affected, and other bunyaviruses have been reported to cause similar congenital defects. Bluetongue Overview of Bluetongue Bluetongue is an infectious arthropod-borne viral disease primarily of domestic and wild ruminants. Infection with bluetongue virus BTV is common in a broad band across the world, which until Other orbiviruses such as Chuzan virus and perhaps epizootic hemorrhagic disease may cause abortion, congenital defects, and neonatal losses similar to bluetongue virus.

They cause congenital abnormalities of the CNS and musculoskeletal system in ruminants. Infection of naive animals can be followed by transplacental infection of the fetus and may produce deformities similar to those seen with viruses such as bluetongue and Cache Valley virus.

Congenital cerebellar hypoplasia in kittens has long been recognized as a result of infection of pregnant queens with feline panleukopenia virus. Infection of pregnant ferrets with feline panleukopenia virus also can result in congenital cerebellar hypoplasia. Deficiency of one or more nutrients during pregnancy may result in congenital defects in the newborn. Microminerals and vitamins are implicated in a variety of developmental defects. Severe deficiencies may interrupt pregnancy or result in weak or nonviable young.

Iodine deficiency may cause congenital goiter or cretinism in all species. Copper deficiency is a cause of enzootic ataxia in lambs. Manganese deficiency can result in congenital limb deformities in calves. What are some other forms related to congenital? What are some words that share a root or word element with congenital? Congenital is most often used formally to refer to medical disorders and defects that a person is born with.

WARSAW, Poland AP — Poland's top court ruled Thursday that a law allowing abortion of fetuses with congenital defects is unconstitutional, shutting a loophole in the predominantly Catholic country's abortion laws that are among Europe's strictest. True or False? Techshot also envisions someday using artificial tissue and organs to help treat diseases, and even congenital defects.

Cunningham-Rundles treats many patients with congenital immune system deficiencies. Early on, my vet back home delivered the crushing news that Scout had a congenital kidney disease.

A descriptive term for a disease or condition that is present at birth. A congenital disease can be either hereditary or acquired. PCBs pass through the placenta, cause congenital poisoning, and remain in human tissues for long intervals. Choose the Right Synonym for congenital innate , inborn , inbred , congenital , hereditary mean not acquired after birth. Examples of congenital in a Sentence The irregularity in my backbone is probably congenital. Recent Examples on the Web Campos-Duffy was joined during the segment by her husband, Sean Duffy, and daughter, Valentina, who was born with Down syndrome and a congenital heart defect.

Nelson, Fox News , 12 Oct. First Known Use of congenital , in the meaning defined at sense 1a. Learn More About congenital. Time Traveler for congenital The first known use of congenital was in See more words from the same year. Style: MLA. Pregnancies were excluded if either chromosomal aberrations or congenital viral infections were reported in the birth registry.

Rates and estimates were also available for specific anomalies. Many countries recommend administration of the acellular pertussis vaccine during the third trimester of pregnancy [26] , [27].

One placebo randomized controlled trial, conducted from to , examined infant congenital anomaly outcomes following maternal Tdap administration during pregnancy. Between 30 and 32 weeks gestation, 33 women received the Tdap vaccine and 15 received a placebo vaccine, with crossover immunization postpartum. In the vaccinated cohort one infant had a congenital anomaly, as compared to two infants with congenital anomalies in the control group [28].

To date, two retrospective observational studies of Tdap administration during pregnancy have been published in the United States; both suggest there is not a significantly increased risk of major congenital anomalies in infants born to mothers who were vaccinated during pregnancy [29] , [30].

The remaining evidence regarding the safety of pertussis containing vaccines is derived from passive surveillance [31]. Maternal and neonatal tetanus remain problematic in geographic areas where childbirth occurs under conditions that do not meet minimum standards of hygiene and immunization coverage of the population is low.

In these regions, women with inadequate immunization history are recommended to receive two doses of tetanus toxoid TT containing vaccine as early as possible during pregnancy [32]. Between and a large prospective study in the United States was conducted that included mother and child pairs evaluated for TT vaccine exposure before 20 weeks gestation. The authors estimated a standardized relative risk SRR of 1. In more recent case-control studies, increased risks of congenital anomalies following maternal TT vaccination were not observed [34] , [35].

In the other, timing of vaccination during pregnancy was not reported [35]. Many vaccines are routinely administered to women of reproductive age, increasing the opportunities for inadvertent vaccination during pregnancy. Thus, continued monitoring of birth outcomes among women inadvertently exposed during pregnancy remains a priority. Inadvertent maternal vaccination with a live virus vaccine is associated with replication of the vaccine virus and likely a more robust maternal inflammatory response than that observed for inactivated vaccines.

However, of greater concern, maternal infections with rubella, varicella, cytomegalovirus and other viruses, during critical periods of fetal development, are associated with specific groupings of congenital anomalies or syndromes [36].

Thus, there is a theoretical risk for inadvertent maternal vaccination with a live virus vaccine to result in a fetal infection and subsequently increase risk for one or more congenital anomalies. A review of the inadvertent administration of live vaccines monovalent or combined rubella, oral poliomyelitis virus, and yellow fever vaccines to pregnant females suggests no evidence of adverse pregnancy outcomes [37]. The incidence of congenital rubella syndrome CRS following inadvertent rubella vaccination of pregnant women has been evaluated in several countries in Europe, the United States, Canada, Iran and Latin America.

Among more than susceptible women inadvertently vaccinated against rubella shortly before or in the first trimester of pregnancy, no cases of CRS were reported [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45].

No specific studies have been conducted on pregnancy outcomes following inadvertent measles or mumps vaccination. Passive surveillance of vaccine exposures prior to conception and during pregnancy has not indicated an increased risk of congenital malformation or spontaneous abortion [46] , but there is not sufficient information to exclude such a risk.

Oral poliovirus vaccine OPV , containing live attenuated poliovirus types 1, 2, and 3, has been widely used since the s to protect pregnant women and neonates against poliomyelitis. The possible development of viremia following immunization and a few cases suggestive of vaccine-associated anomalies including an unexplained report about fatal spinal cord neuronal damage following maternal immunization in an immune mother have been documented [47].

However, no population-based controlled studies are available to confirm the significance of these individual reports. There was no observed increase in the rates of growth retardation, perinatal deaths, prematurity or congenital anomalies in the infants exposed to OPV in utero in comparison with the expected rates [48].

Yellow fever vaccination has been documented in several hundred pregnant women. The risks of adverse outcome of pregnancy and childbirth appear to be similar to those in the general population [49] , [50].

Data from a U. The rate of occurrence of congenital anomalies from prospective reports in the registry was similar to reported rates in the general U. The latter have been mostly passive, voluntary reporting registry surveillance, which extended for the 4vHPV vaccine until and is ongoing for the 9vHPV vaccine since licensure by the US FDA in As of today, there are no data to suggest an increased risk of congenital malformations following exposure to HPV vaccines during pregnancy, but overall numbers of cases have been low, potentially limiting statistical power and precluding the ability to definitively rule out associations of the HPV vaccines with specific anomalies.

A pooled analysis of 42 pre-licensure clinical studies of the 2vHPV vaccine that included pregnancies in which date of last menstrual period occurred between 30 days prior to 45 days after vaccination did not find an increased risk of congenital anomalies, when compared to controls with similar timing of vaccination 1. Similarly, a pooled analysis of five pre-licensure clinical studies of the 4vHPV vaccine did not find a significant difference in the rate of congenital anomalies when comparing pregnant women receiving vaccination with pregnant women receiving placebo 2.

Voluntary reporting is known for underreporting of congenital anomalies if not detected at birth, and over-reporting bias for anomalies is common with the use of retrospective reports.

The manufacturer-supported registries have therefore only used prospective inadvertent vaccine exposure reports for the calculation of the congenital anomaly rates [54]. The manufacturer-sponsored registries observed overall rates of major congenital malformations that were consistent with the background rates in the populations [5 of live born infants 2.

Additionally, in an analysis of 4vHPV vaccine reports submitted between June and December to VAERS, only two major congenital malformations were reported out of all infants born to women who received 4vHPV during pregnancy [57]. Published data from a formal epidemiologic study on the safety of HPV vaccines during pregnancy in the post-licensure setting come from an observational cohort study in the Clinical Practice Research Datalink; no difference was observed in the percentage of congenital malformations resulting from pregnancies in which pregnancy initiation occurred between 30 days prior to 45 days after 2vHPV vaccination 7 of pregnancies, 5.

Nakalembe et al. Of the 14 studies, four included information related to pregnancy outcomes; no difference was found between groups in these 4 studies. Congenital anomalies were reported in a total of 32 infants and 9 fetuses and rates did not differ between groups 20 in the 9vHPV group and 21 in the 4vHPV group.

Evidence on the safety of administration of meningococcal vaccination during pregnancy is scarce. A systematic review conducted in identified 6 studies evaluating the safety of Meningococcal Polysaccharide Vaccine MPSV in pregnancy [60]. None of the included studies suggested any adverse outcomes, including birth defects, for infants born to mothers who received MPSV during pregnancy.

However, the total study population included women which may be too small to evaluate rare outcomes such as congenital anomalies. The safety information on meningococcal conjugate vaccines MCV is derived from passive surveillance [61] , [62].

These data do not suggest harmful events on birth outcomes, including congenital anomalies, when MCV is administrated to pregnant women. To date, no data are available on the safety of new Meningococcal B vaccines when administered during pregnancy. The evidence on potential risks for congenital anomalies following maternal immunization is mostly reassuring. However, studies to date have been limited by insufficient sample sizes, varied definitions for outcomes, and use of non-biologically feasible exposure windows.

However, specific isolated defects generally occur at rates of 1 per 10, to 1 per , births [64]. Given the variability in types and causes of birth defects, future studies of maternal vaccine safety will need much larger sample sizes or alternative approaches e. Subtle differences exist among the various definitions for congenital anomalies used by organizations specializing in congenital anomalies and development.

NBDPN subcategorizes birth defects into major and minor anomalies. The definitions used by these organizations focus on both structural and functional abnormalities that are present at birth that have significant health consequences. Please see Table 1 for a complete list of these organizations and the definitions used. List of organizations focused on research related to congenital anomalies, specific term and definitions used by each organization.

There is no uniformly accepted definition of congenital anomalies, or more specifically, of congenital anomalies following maternal immunization. This is a missed opportunity, as data comparability across trials or surveillance systems would improve data interpretation and promote the scientific understanding of the event.

Through the provision of standardized case definitions and guidelines, this document is intended to improve reliability and comparability of data collected from immunized patients and controls in clinical trials, as well as provide a framework for consistently monitoring the safety of vaccines currently recommended during pregnancy or available to women of reproductive age. Such data can be used in the assessment of whether or to what extent a vaccine administered during pregnancy may increase a woman's risk for having a live birth or fetal demise with one or more congenital anomalies.

The case definitions and guidelines are intended to be applicable in diverse geographic, administrative, and cultural regions, adaptable to both high and low resource settings. OR pregnancy. OR risk ADJ2 f? All abstracts were screened for possible reports of congenital anomalies following immunization. Over 60 articles with potentially relevant material were reviewed in more detail, in order to identify studies using case definitions or, in their absence, providing clinical descriptions of the case material.

Multiple general medical, pediatric and infectious disease text books were also searched. The literature search yielded publications in which terminology was inconsistent. An inventory comprising 6 relevant case definitions Table 1 of congenital anomalies was made available to working group members.

Our workgroup suggests that isolated congenital anomalies can be stratified into three broad categories:. Internal structural defects e. As previously mentioned, congenital anomalies might occur in isolation single defect or as a group of defects multiple defects which are often part of well-described associations e.

In addition, there may be overlap between categories for certain congenital anomalies. For example, chromosomal defects are often associated with major internal structural defects.

For external structural, internal structural and functional defects, the timing of clinical recognition varies by defect type and by access to health care.

For example, in high resource settings, many structural congenital anomalies are diagnosed prenatally through ultrasound or other advanced imaging.

Similarly, in high resource settings, functional anomalies may be diagnosed through genetic screening following amniocentesis, chorionic villi sampling, or maternal blood testing. If not detected prenatally, including in low resource settings, external structural defects are usually evident at the time of birth. In contrast, it is common in both high and low resource settings for both internal structural defects and functional defects to be diagnosed in the days, weeks, or months following birth.

The diverse range of congenital anomalies and their varied clinical presentation highlights the difficulty of assigning a single classification system. In addition, major congenital anomalies may result in spontaneous abortion, stillbirth or an elective therapeutic abortion, and therefore may not be captured if data collection is limited to live births.

It is therefore emphasized, that the possibility of congenital anomalies should always be considered when evaluating etiology for a spontaneous abortion or stillbirth. Within the definition context, we have assigned four levels of diagnostic certainty to each category listed above. For each category, a fifth level is included to indicate that the event does not meet the case definition for congenital anomalies.

The case definition has been formulated such that the Level One definition is highly specific for the condition. As maximum specificity normally implies a loss of sensitivity, additional diagnostic levels have been included in the definition, offering a stepwise increase of sensitivity from Level One down to Level Three, while retaining an acceptable level of specificity at all levels. In this way it is hoped that all possible cases of congenital anomalies can be captured. The diagnostic levels must not be misunderstood as reflecting different grades of clinical severity.

They instead reflect diagnostic certainty for the presence of a particular congenital anomaly. When evaluating the possibility of a congenital anomaly, conditions and syndromes due to either known maternal conditions e.

It needs to be re-emphasized that the grading of definition levels is entirely about diagnostic certainty, not clinical severity of an event. Thus, clinically severe anomalies may appropriately be classified as Level Two or Three rather than Level One if there is no evidence of a specific confirmatory test.

However, detailed information about the severity of the event should always be recorded, as specified by the data collection guidelines.

We have attempted to provide adequate diagnostic specificity without being overly restrictive in order to create definitions that are applicable in both high and low resource settings.

With regards to specific pathology, radiology, or laboratory findings necessary to meet the case definition, these findings will vary based on the specific congenital anomaly being evaluated. The current definitions refer to broad categories of anomalies; more comprehensive definitions for specific congenital anomalies, e. We have included appendices of specific major congenital anomalies listed by groups across the globe conducting birth defects surveillance.

In addition, our classification is specific to major anomalies, affecting survival, physical or social functioning. Classification of minor anomalies, occurring as isolated or multiple defects, is beyond the scope of this paper.

A treatment response or its failure, is not in itself diagnostic, and may depend on variables like clinical status, time to treatment, and other clinical parameters. For congenital anomalies, treatment is often a surgical intervention. In the absence of standard pathology, radiology, or laboratory findings, documentation of specific treatments e.

Our definitions account for the possibility of an early surgical correction or, for functional anomalies, a definitive treatment e. It is widely recognized that first trimester is the most critical period for teratogen exposure during pregnancy with regards to subsequent effects on fetal development [66].