scholarly journals Birth outcomes of cases with different congenital heart defects - a population-based study

2015 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
Attila Vereczkey ◽  
Balázs Gerencsér ◽  
Andrew E Czeizel ◽  
István Szabó

<p><strong>Background:</strong> In general, previous epidemiological studies evaluated congenital heart defects (CHDs) together. The aim of the present study was to identify possible etiological factors of different CHD-entities, because the underlying causes are unclear in the vast majority of patients.</p><p><strong>Objectives:</strong> Different CHD-entities as homogeneously as possible with confirmed diagnoses were analyzed in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities.</p><p><strong>Methods</strong>: 3,750 live-born singleton CHD-patients were analyzed according to birth outcomes, i.e. gestational age at delivery and birth weight, the rate of preterm birth, low birthweight and small for gestational age.</p><p><strong>Results</strong>: The major findings of the study showed that cases with different CHD-entities had shorter gestational age at delivery and lower mean birth weight, and these variables associated with a higher rate of preterm birth and particularly with a much higher rate of low birthweight and small for gestational age. This study showed the importance of sex in the birth outcomes of some CHD-entities. The question is why several CHD-entities manifested more frequently in newborns with intrauterine growth restriction because fetal heart has a passive role before birth without pulmonary circulation.</p><p><strong>Conclusions:</strong> The birth outcomes of cases indicate the effect of CHDs for fetal development. In addition maternal confounders have to consider. Finally, CHDs and intrauterine growth restriction as two developmental errors may have a common route, thus fetal growth and birthweight associated gene polymorphisms may have a role in the origin of CHDs.</p>

2020 ◽  
Author(s):  
Juliane Ankert ◽  
Tanja Groten ◽  
Mathias W. Pletz ◽  
Sasmita Mishra ◽  
Gregor Seliger ◽  
...  

Abstract Background: Migrant women may have an increased risk of adverse birth outcomes. This study analyses the occurrence of low birth weight, preterm birth and intrauterine growth restriction (IUGR) in pregnant migrants. Method: Cross-sectional study of 82 mother-child pairs of pregnant migrants attending medical care in Germany.Results: Median age was 27 years, 49% were of oriental-asian ethnicity and median year of migration was 2015. At least one previous pregnancy was reported in 76%. Delivery mode was caesarian section in 40%. Median gestational age was 39.7 weeks. Preterm birth occurred in 6.1%. Median gestational age for preterm birth was 32.3 weeks. Low birth weight (<2500 g) occurred in 6.1%. Birth weights below the 10th percentile of birth weight for gestational age were observed in 8.5% of the total cohort. Conclusions: Compared to German data no increased occurrence of low birth weight, preterm birth or IUGR was found. Of note, rate of caesarian section was higher than in the general population for reasons yet to be identified. The authors propose stratification according to migration status for the national documentation of birth outcomes in Germany.Trial registration: ClinicalTrails.gov, NCT03158298. Registered 18 May 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03158298


Author(s):  
Suman Maity ◽  
Nahed El-hassan ◽  
Anthony Goudie ◽  
Jeffrey R Kaiser ◽  
Wendy N Nembhard

Children with congenital heart defects (CHD) have impaired cognitive development. The objective was to determine if children with CHDs differed in academic performance during elementary and middle school years from children without CHDs. Data from the state birth defects registry, Arkansas Reproductive Health Monitoring System (ARHMS), birth certificate records, and achievement test-scores (grades 3-8) from the Arkansas Department of Education were linked using unique identifiers for children born between 2000-2011 in Arkansas. Cases were identified using 6-digit British Paediatric Association codes and matched controls were assigned from birth certificate data. Proficiency (yes/no) on achievement tests was determined using standard thresholds per grade. Data were stratified based on sex, gestational age, and birth weight. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from multivariate logistic regression adjusting for maternal education level and age, race/ethnicity, and infant sex. A total of 3,730 children with CHDs and 7,385 children without CHDs were evaluated. Children with CHD were less likely to be proficient in early elementary school grades for mathematics (3rd: OR=0.72, 95% CI: 0.59, 0.87; 4th: OR=0.77, 95% CI: 0.62, 0.95) and literacy (3rd: OR=0.75, 95% CI: 0.63, 0.89; 4th: OR=0.72, 95% CI: 0.58, 0.90). The trend of being less proficient associated with CHD remained mostly consistent with sex, gestational age, and birth weight. In multivariate analysis, CHD was negatively associated with being proficient in mathematics and literacy. Maternal education (1-3 years beyond high school) was positively associated with test proficiency. Additionally, non-Hispanic (NH) black children had lower odds of being proficient compared to NH white children. Educational performance was negatively associated with CHD in early elementary grades; there was no difference in later grades. However, larger sample sizes in later grades are necessary for reliable estimates. Maternal education and race/ethnicity were significant factors associated with childhood educational performance.


2007 ◽  
Vol 92 (7) ◽  
pp. 2758-2763 ◽  
Author(s):  
Rikke Beck Jensen ◽  
Signe Vielwerth ◽  
Torben Larsen ◽  
Gorm Greisen ◽  
Henrik Leffers ◽  
...  

Abstract Context: A common polymorphism in the GH receptor (GHR) gene has been linked to increased growth response in GH-treated patients. No former study has focused on the association to prenatal growth. Objective: The aim of the study was to evaluate the association between the d3-GHR isoforms and spontaneous pre- and postnatal growth. Design: A prospective study was conducted on third-trimester fetal growth velocity (FGV), birth weight, birth length, and postnatal growth. Setting: The study was conducted at Copenhagen University Hospital. Participants: A total of 115 healthy adolescents were divided into those born small for gestational age (SGA) and appropriate for gestational age with or without intrauterine growth restriction. Main Outcome Measures: FGV was measured by serial ultrasonography, birth weight, birth length, and adolescent height. Isoforms of the d3-GHR gene (fl/fl, d3/fl, and d3/d3) were determined. Results: The prevalence of the d3-GHR isoforms was 50% but differed among the groups (P = 0.006), with a high prevalence (88%) in the group born SGA with verified intrauterine growth restriction. The d3-GRH allele were associated with decreased third-trimester FGV (P = 0.05) in SGA subjects. In the entire cohort, carriers of the d3-GHR allele had a significantly increased height (−0.10 vs. 0.34 sd score; P = 0.017) and change in height from birth to adolescence compared with carriers of the full-length GHR allele (0.57 vs. −0.02 sd score; P = 0.005). Conclusions: This study showed an increased spontaneous postnatal growth velocity in the carriers of the d3-GHR allele. Interestingly, we found the opposite effect on prenatal growth in the SGA group, with a decreased FGV in carriers of the d3-GHR allele.


2016 ◽  
Vol 10 ◽  
pp. CMPed.S40070 ◽  
Author(s):  
Deepak Sharma ◽  
Sweta Shastri ◽  
Pradeep Sharma

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.


2019 ◽  
Vol 4 (3) ◽  
pp. 102-112
Author(s):  
E. V. Rudaeva ◽  
V. G. Mozes ◽  
V. V. Kashtalap ◽  
I. S. Zakharov ◽  
S. I. Yelgina ◽  
...  

Annually, there > 30,000 infants are born with congenital heart defects; in different populations, the prevalence of congenital heart disease (CHD) varies from 2.4 to 14.15%. Women with CHD planning pregnancy are at increased risk of heart failure, arrhythmias, cerebrovascular disease, and embolism. In such patients, pregnancy course is complicated by intrauterine growth restriction, pre-eclampsia, and preterm birth. Their newborns generally have a low birth weight and high risk of congenital malformations including heart defects. European Society of Cardiology (ESC) developed risk assessment-based guidelines to optimise the management of pregnant women with CHD. This approach requires a cooperation of obstetrician-gynecologists, general practitioners, and cardiologists.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hafi Saad ◽  
Marlene Sinclair ◽  
Brendan Bunting

Abstract Background Congenital Heart Defects (CHD) is the most commonly occurring congenital anomaly in Europe and a major paediatric health care concern. Investigations are needed to enable identification of CHD risk factors as studies have given conflicting results. This study aim was to identify maternal sociodemographic characteristics, behaviours, and birth outcomes as risk factors for CHD. This was a population based, data linkage cohort study using anonymised data from Northern Ireland (NI) covering the period 2010-2014. The study cohort composed of 94,067 live births with an outcome of 1162 cases of CHD using the International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes and based on the European Surveillance of Congenital Anomalies (EUROCAT) grouping system for CHD. CHD cases were obtained from the HeartSuite database (HSD) at the Royal Belfast Hospital for Sick Children (RBHSC), maternal data were extracted from the Northern Ireland Maternity System (NIMATS), and medication data were extracted from the Enhanced Prescribing Database (EPD). STATA version 14 was used for the statistical analysis in this study, Odds Ratio (OR), 95% Confident intervals (CI), P value, and logistic regression were used in the analysis. Ethical approval was granted from the National Health Service (NHS) Research Ethics Committee. Result In this study, a number of potential risk factors were assessed for statistically significant association with CHD, however only certain risk factors demonstrated a statistically significant association with CHD which included: gestational age at first booking (AOR = 1.21; 95% CI = 1.04-1.41; P < 0.05), family history of CHD or congenital abnormalities and syndromes (AOR = 4.14; 95% CI = 2.47-6.96; P < 0.05), woman’s smoking in pregnancy (AOR = 1.22; 95% CI = 1.04-1.43; P < 0.05), preterm birth (AOR = 3.01; 95% CI = 2.44-3.01; P < 0.05), multiple births (AOR = 1.89; 95% CI = 1.58-2.60; P < 0.05), history of abortion (AOR = 1.12; 95% CI = 1.03-1.28; P < 0.05), small for gestational age (SGA) (AOR = 1.44; 95% CI = 1.22-1.78; P < 0.05), and low birth weight (LBW) (AOR = 3.10; 95% CI = 2.22-3.55; P < 0.05). Prescriptions and redemptions of antidiabetic (AOR = 2.68; 95% CI = 1.85-3.98; P < 0.05), antiepileptic (AOR = 1.77; 95% CI = 1.10-2.81; P < 0.05), and dihydrofolate reductase inhibitors (DHFRI) (AOR = 2.13; 95% CI = 1.17-5.85; P < 0.05) in early pregnancy also showed evidence of statistically significant association with CHD. Conclusion The results of this study suggested that there are certain maternal sociodemographic characteristics, behaviours and birth outcomes that are statistically significantly associated with higher risk of CHD. Appropriate prevention policy to target groups with higher risk for CHD may help to reduce CHD prevalence. These results are important for policy makers, obstetricians, cardiologists, paediatricians, midwives and the public.


2018 ◽  
Vol 8 (3) ◽  
pp. 82-89
Author(s):  
Tran Thao Nguyen Nguyen ◽  
Van Duc Vo ◽  
Ngoc Thanh Cao

Objectives: To identify the values of CPR in intrauterine growth restriction and evaluate the correlation between cerebroplacental ratio and adverse outcomes in intrauterine growth restriction. Material and methods: A prospective study was conducted on 74 cases of intrauterine growth restriction with an estimated fetal weight less than 10th percentile, at Departement of Obstetric and Gynecology of Hue University of Medicine and Pharmacy from 05/2016 – 05/2017. CPR was calculated by PIMCA/PIUA.. The adverse outcomes included gestational age at delivery, methods used to delivery, APGAR score below 7 at 1 minutes and 5 minutes, admission at NICU, perinatal deaths, neonatals deaths. Results: The mean of CPR in group of early IUGR and late IUGR were 0.55 ± 0.14, 1.59 ± 0.69, respectively. The mean of CPR in group IUGR with an estimated fetal weight under the 3th percentile was 1.49 ± 0.76, lower than the mean of CPR in group IUGR with an estimated fetal weight from 3th percentile to 10th percentile. With cut – off at 1, CPR < 1 had the higher prevalence in group of early IUGR, in group IUGR with the estimated fetal weight below the 3th percentile, in group IUGR with hypoamniotic or oligohydramnios. The mean of gestational age at delivery of group IUGR with CPR < 1 and CPR >1 were 37.00 ± 3.18, and 38.59 ± 1.76, respectively. The rate of emergency cesarean section deliveries in the CPR < 1 and CPR > 1 group were 68.75% and 39.65%, respectively (p <0.05). Percentage of neonatal with APGAR ≤ 7 at 1 minute in the group with CPR < 1 and CPR > 1 were 56.25% and 22.41%, respectively. Rate of prenatal death was 12.5 in group IUGR with CPR < 1. Conclusion: There was a strong correlation between CPR and adverse outcomes in intrauterine growth restriction. Key words: intrauterine growth restriction, CPR ratio, middle cerebro artery, umbilical artery


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