Total number of newborns born in Covid-19 pandemic period is 347839 vs 395,728 newborns born in the same time period before Covid-19. Table 1 presents demographic characteristics of the mothers who have given birth during these time periods. Variables associated with neonatal anomalies include maternal afge and maternal education before and during Covid-19 pandemic (P value < 0.00001), and the type of delivery in the pre-Covid-19 time (P = 0.01).

2012 (0.58) of newborns born during Covid-19 pandemic had congenital abnormalities and 1868 (0.47) newborns with congenital abnormalities were born in the same time period pre-Covid-19. The incidence of congenital anomalies in the Iran was higher during Covid-19 than before Covid-19; the chi-square value is 40.36 (P value < 0.00001). Although the prevalence of congenital anomalies has increased in the Covid-19 period, neonatal outcomes among abnormal newborns was no significant difference compared to the pre-Covid-19 abnormal babies (Table 2).

As shown in Table 3, some types of anomalies have increased significantly during the Covid-19 pandemic. CNS and genitourinary abnormalities in newborns of women who have spent their entire pregnancy (trimester one, two and three) during Covid-19 pandemic have increased significantly compared to the same period last year.

Subtypes of CNS anomalies in IMAN were: anencephaly, encephalocele, microcephaly, hydrocephaly, Arnold chiari, spina bifida, myelomeningocele, holoprosencephaly, Dandy Walker, and others. Spina bifida was the most common abnormality in both time periods, but there was a statistically significant increase in its prevalence during Covid-19 (33.6% vs 24%; Chi-square = 4.69, p-value = 0.03). Another significant difference was detectable in anencephaly subtype (26% vs 16%; Chi-square = 5.94, p-value = 0.01). There was no significant difference in other subgroups.

In the current study, genitourinary anomalies include renal agenesis, hydronephrosis, cryptorchidism, epispadias, hypospadias, ectopic kidney, gender ambiguity, polycystic kidney, bladder exstrophy. Hydronephrosis as the most prevalent subtype, showed a significant increase in the Covid-19 pandemic (58% vs 43.5%; Chi-square = 11.93, p-value = 0.0005). Polycystic kidney prevalence was 25% during Covid-19 vs 17% before pre-Covid-19 (Chi-square = 5.41, p-value = 0.01). The last significant difference was seen in the renal agenesis subgroup (20% vs 13%; Chi-square = 5.15, p-value = 0.02).