scholarly journals Assessing the risk of preterm birth for newborns with congenital heart defects conceived following infertility treatments: a population-based study

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000836 ◽  
Author(s):  
Karim Tararbit ◽  
Nathalie Lelong ◽  
François Goffinet ◽  
Babak Khoshnood
Keyword(s):  
Preterm Birth ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Population Based ◽  
Multiple Pregnancies ◽  
Maternal Characteristics ◽  
Paris Area ◽  
Infertility Treatments

ObjectivesTo quantify the risk of preterm birth (PTB) for newborns with congenital heart defects (CHDs) conceived following infertility treatments, and to examine the role of multiple pregnancies in the association between infertility treatments and PTB for newborns with CHD.MethodsWe used data from a population-based, prospective cohort study (EPICARD EPIdémiologie des CARDiopathies congénitales) including 2190 newborns with CHD and excluding cases with atrial septal defects born to women living in the Greater Paris area between May 2005 and April 2008. Statistical analysis included logistic regression to take into account potential confounders (maternal characteristics, invasive prenatal testing, CHD prenatal diagnosis, medically induced labour/caesarean section before labour, birth year). The role of multiple pregnancies was assessed using a path-analysis approach, allowing decomposition of the total effect of infertility treatments on the risk of PTB into its indirect (mediated by the association between infertility treatments and multiple pregnancies) and direct (mediated by mechanisms other than multiple pregnancies) effects.ResultsPTB occurred for 40.6% (95% CI 28.7 to 52.5) of newborns with CHD conceived following infertility treatments vs 12.7% (95% CI 11.3 to 14.2) for spontaneously conceived newborns (p<0.001). After taking into account potentially confounding factors, infertility treatments were associated with a 5.0-fold higher odds of PTB (adjusted OR=5.0, 95% CI 2.9 to 8.6). Approximately two-thirds of this higher risk of PTB associated with infertility treatments was an indirect effect (ie, due to multiple pregnancies) and one-third was a direct effect (ie, not mediated by multiple pregnancies).ConclusionNewborns with CHD conceived following infertility treatments are at a particularly high risk of PTB, exposing over 40% of them to the ‘double jeopardy’ of CHD and PTB.

scholarly journals Preterm Birth (PTB) and Congenital Heart Defects (CHD): A Population-Based Study

2011 ◽  
Vol 70 ◽  
pp. 417-417 ◽  
Author(s):  
E Laas ◽  
N Lelong ◽  
A -C Thieulin ◽  
L Houyel ◽  
D Bonnet ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Population Based ◽  
Population Based Study

scholarly journals Impact of prenatal diagnosis on survival of newborns with four congenital heart defects: a prospective, population-based cohort study in France (the EPICARD Study)

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018285 ◽  
Author(s):  
Babak Khoshnood ◽  
Nathalie Lelong ◽  
Lucile Houyel ◽  
Damien Bonnet ◽  
Morgane Ballon ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Infant Mortality ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Population Based ◽  
Postnatal Diagnosis ◽  
Paris Area ◽  
The Impact ◽  
Risk Ratios

Objectives(1) Assess the population-level probability of prenatal diagnosis and termination of pregnancy for fetal anomaly for four major congenital heart defects; (2) Examine, using population-based data, the relation between timing of (prenatal vs postnatal) diagnosis and risk of infant (ie, < 1 year) mortality for four major congenital heart defects (CHDs).DesignPopulation-based cohort (the EPIdémiologie des CARDiopathies congénitales) study.SettingGreater Paris area (Paris and its surrounding suburbs).PatientsThree hundred and fifty-four cases of four major CHDs, including functionally univentricular heart (FUH, N=132), d-transposition of great arteries (d-TGA, N=85), tetralogy of Fallot (TOF, N=60) and coarctation of aorta (CoA, N=77). Statistical analysis included the Mantel-Haenszel method and a test of homogeneity of risk ratios.ResultsApproximately 95% of FUH, more than two-thirds of d-TGA and TOF, and 40% of CoA were prenatally diagnosed. Overall, we did not find any statistically significant association between timing of (prenatal vs postnatal) diagnosis of CHD and risk of infant mortality (Mantel-Haenszel risk ratio 1.1, 95% CI 0.5 – 2.7); and the differences between the risk ratios of the association between prenatal diagnosis and infant mortality across the four CHDs was not statistically significant.ConclusionThese results imply that at least in the settings where specialised services are readily available, survival may no longer be the most relevant outcome, or the best criterion, for evaluating the impact of prenatal diagnosis on the outcome of CHD. The beneficial effects of prenatal diagnosis may be better sought by looking at more ’subtle' or long-term neurodevelopmental outcomes.

Preterm Birth and Congenital Heart Defects: A Population-based Study

PEDIATRICS ◽  
2012 ◽  
Vol 130 (4) ◽  
pp. e829-e837 ◽  
Author(s):  
E. Laas ◽  
N. Lelong ◽  
A.-C. Thieulin ◽  
L. Houyel ◽  
D. Bonnet ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Population Based ◽  
Population Based Study

Role of Ultrasonography in Early Gestation in the Diagnosis of Congenital Heart Defects

2010 ◽  
Vol 29 (5) ◽  
pp. 817-821 ◽  
Author(s):  
Reem S. Abu-Rustum ◽  
Linda Daou ◽  
Sameer E. Abu-Rustum
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Early Gestation

Abstract 18284: Incidence of Epilepsy is Elevated in Children and Young Adults With Congenital Heart Defects Compared With the General Population: A Nationwide Cohort Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Morten Olsen ◽  
Bradley S Marino ◽  
Michelle Leisner ◽  
Jessica G Woo ◽  
Nicolas L Madsen
Keyword(s):  
Young Adults ◽  
Preterm Birth ◽  
General Population ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Birth Registry ◽  
Registration System ◽  
Children And Young Adults

Perioperative seizures related to surgery for congenital heart defects (CHD) are well described; however, few data exist on the long-term risk of epilepsy in patients with CHD. We aimed to estimate the incidence of epilepsy in children and young adults with CHD compared with the general population. Methods: Utilizing data from the Danish National Registry of Patients (DNRP) we identified all patients diagnosed with CHD before the age of 15 years between 1980 and 2010 who were born during the same period. The DNRP is a nationwide hospital discharge registry covering all Danish hospitals. Previously validated methodology using the DNRP was applied to measure the outcome, epilepsy, as well as presence of extra cardiac defects (ECD) and/or syndromes. We used the Danish Medical Birth Registry to identify preterm birth (gestational age<37 weeks). For each CHD subject, we identified 10 controls from the general population using the Danish Civil Registration System, matched by sex and birth year. A unique personal identifier assigned at birth and used in all Danish public registries enabled virtually complete follow up for migration, death, or epilepsy until January 1, 2013. We computed cumulative incidences and hazard ratios (HR) (split at 5 years of age to obtain proportional hazards) of time from CHD diagnosis (index date for controls) to epilepsy. Results: We identified 14,665 CHD subjects with a median age at diagnosis of 2 (IQR 19) months. By 15 years of age, the cumulative incidence of epilepsy was 4% among CHD subjects. The HR of epilepsy among CHD subjects compared with the control cohort was 3.7 (95% CI: 3.2-4.3) below 5 years of age, and 2.4 (95% CI: 2.1-2.7) from 5 to 33 years of age. In the older age group, HR for patients with severe CHD was 2.8 (95% CI: 2.3-3.5), and for mild and moderate CHD was 2.2 (95% CI: 1.8-2.6). After exclusion of all subjects with ECDs and/or syndromes and preterm birth, corresponding HRs were 2.2 (95% CI: 1.6-3.0) and 1.7 (95% CI: 1.3-2.2), respectively. Conclusion: The epilepsy risk was markedly increased in CHD subjects compared with the age and gender matched controls. These findings add evidence to support the importance of developing neuro-protective measures and potentially long-term epilepsy surveillance strategies in the CHD population.

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