Maternal Smoking During Pregnancy and the Risk of Congenital Heart Defects in Offspring: A Systematic Review and Metaanalysis

2012 ◽  
Vol 34 (2) ◽  
pp. 398-407 ◽  
Author(s):  
Laura J. Lee ◽  
Philip J. Lupo
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Maternal Smoking ◽  
Congenital Heart ◽  
Heart Defects ◽  
Smoking During Pregnancy ◽  
Maternal Smoking During Pregnancy

Abstract P140: Maternal Smoking During Pregnancy and Risk of Congenital Heart Defects: A Systematic Review and A Meta-Analysis

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura Lee ◽  
Philip Lupo
Keyword(s):  
Congenital Heart Defects ◽  
Maternal Smoking ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Ventricular Septal Defects ◽  
Smoking During Pregnancy ◽  
Septal Defects ◽  
Maternal Smoking During Pregnancy

Objective: Congenital heart defects (CHDs) are the most common group of structural malformations occurring in approximately 1 out of every 100 births. In addition to being the most prevalent birth defect, CHDs are the leading cause of death due to congenital malformations. Despite their prevalence and clinical importance, little is known about the etiology of CHDs, and there are currently no strategies for reducing their prevalence. Maternal smoking during pregnancy has been suggested as a potential risk factor for congenital heart defects, but the evidence is inconclusive. We systematically reviewed epidemiological studies and conducted a meta-analysis of the association between maternal cigarette smoking during pregnancy and the risk of CHDs among the infants. Methods: From a search of published literature through July 2011, we extracted 35 original human epidemiological studies that examined the association between maternal smoking during pregnancy (including a month before conception) and the risk of CHDs in offspring. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted from each study or calculated from available data, comparing smoking to no smoking during pregnancy. Summary risk estimates were also calculated for a number of CHDs subtypes (e.g., conotruncal defects, ventricular septal defects) using both fixed- and random-effects models. Random effects estimates were reported if there was evidence of heterogeneity among the studies. Effects of paternal and environmental smoking were not considered in our analysis. Results: We observed statistically significant positive association between maternal smoking anytime during pregnancy and the risk of CHDs (OR = 1.10; 95% CI: 1.01–1.19; number of cases (n) = 19,552). Additionally, we found a positive and significant association between maternal smoking and the risk of conotruncal defects in offspring (OR = 1.14; 95% CI: 1.03–1.26; n = 1953). Although not statistically significant, stronger elevated risks were observed for ventricular septal defects (OR = 1.11; 95% CI: 0.87–1.41; n = 4605) and atrial septal defects (OR = 1.34; 95% CI: 0.97–1.86; n = 565). Conclusion: Our systematic review and meta-analysis suggest maternal smoking is modestly associated with an increased risk of CHDs and some CHDs subtypes. This work adds to the existing body of evidence that implicated maternal smoking during pregnancy as a possible risk factor for CHDs. Future studies should consider evaluating paternal and environmental smoking exposure to better understand the relationship between smoking and CHDs.

scholarly journals Children Born with Congenital Heart Defects and Growth Restriction at Birth: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (9) ◽  
pp. 3056 ◽  
Author(s):  
Ali Ghanchi ◽  
Neil Derridj ◽  
Damien Bonnet ◽  
Nathalie Bertille ◽  
Laurent J. Salomon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Growth Restriction

Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted. Objective: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA). Methods: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model. Results: The pooled proportion of SGA in all CHD was 20% (95% CI 16%–24%) and 14% (95% CI 13%–16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%–37%) for Tetralogy of Fallot to 12% (95% CI 7%–18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010. Conclusion: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.

Maternal Smoking and Congenital Heart Defects, National Birth Defects Prevention Study, 1997-2011

2021 ◽  
Author(s):  
Elijah H. Bolin ◽  
Yevgeniya Gokun ◽  
Paul A. Romitti ◽  
Sarah C. Tinker ◽  
April D. Summers ◽  
...  
Keyword(s):  
Birth Defects ◽  
Congenital Heart Defects ◽  
Maternal Smoking ◽  
Congenital Heart ◽  
Heart Defects ◽  
Prevention Study

scholarly journals Prevalence of congenital heart defects in neuroblastoma patients: a cohort study and systematic review of literature

2008 ◽  
Vol 168 (9) ◽  
pp. 1081-1090 ◽  
Author(s):  
Klaartje van Engelen ◽  
Johannes H. M. Merks ◽  
Jan Lam ◽  
Leontien C. M. Kremer ◽  
Manouk Backes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Study ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Review Of Literature

Maternal Smoking and Congenital Heart Defects

PEDIATRICS ◽  
2008 ◽  
Vol 121 (4) ◽  
pp. e810-e816 ◽  
Author(s):  
S. Malik ◽  
M. A. Cleves ◽  
M. A. Honein ◽  
P. A. Romitti ◽  
L. D. Botto ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Maternal Smoking ◽  
Congenital Heart ◽  
Heart Defects

scholarly journals Parachute tricuspid valve: a systematic review

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Shi-Min Yuan
Keyword(s):  
Systematic Review ◽  
Survival Rate ◽  
Right Ventricular ◽  
Tricuspid Valve ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Diagnostic Methods ◽  
Interventional Treatment ◽  
Presenting Symptoms

Abstract Background A parachute tricuspid valve is a very rare congenital cardiac anomaly. Its morphological features and clinical implications have not been sufficiently described so far. The purpose of the present systematic review is to disclose the morphological and clinical characteristics of parachute tricuspid valve, and to discuss its diagnostic methods, treatments and patients’ outcomes. Main body The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines were followed in this systematic review. Publications were systematically searched in the PubMed, Highwire Press, and the Cochrane Library databases. By comprehensive retrieval of the pertinent literature published between 1979 and 2019, 13 reports were collected with 14 patients recruited into this study. Their ages ranged from neonate to 52 years old with a median age of 23 years. Tricuspid valve regurgitation of a less-than-severe degree was seen in 6 (60%) patients, tricuspid valve stenosis was present in 3 (30%) patients and normally functioning tricuspid valve was noted in 1 (10%) patient. All patients had a single papillary muscle in the right ventricle. The chordae tendineae could be normal in length and thickness, or elongated, or shortened and thickened. Forty percent of the patients were asymptomatic or with only mild symptoms and did not need a surgical or interventional therapy, and 6 (60%) patients were indicated for a surgical/interventional treatment due to their severe presenting symptoms, associated congenital heart defects, and the resultant severe right ventricular inflow obstruction and (or) tricuspid stenosis. Patients’ outcomes varied depending on the substantial status of the patients with a survival rate of 70% and mortality rate of 30%. Conclusion A few patients with a parachute tricuspid valve are asymptomatic or only with mild symptoms and a surgical or interventional treatment is not required. The surgical/interventional indications for parachute tricuspid valve patients are their severe presenting symptoms, associated congenital heart defects, and the resultant severe right ventricular inflow obstruction and (or) tricuspid stenosis. The survival rate of this patient setting is satisfactory.

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