Noninherited Risk Factors of Congenital Heart Defects in Offspring: A Revi

Prognosis of children with congenital heart defects (CHDs) continues to improve with advancement in technology and training in pediatric cardiology and cardiac surgery; however, lack of information about risk factors for malformations in cardiovascular development impeded the prevention of CHDs. Etiology of CHDs are complex and possibly lies within the interaction of environmental exposures and inherited factors. Studies found multiple maternal environmental exposures, including living in newly renovated rooms, residential proximity to main traffic, smoking and maternal occupation as manual worker significantly associated with CHDs. Advanced maternal age, low socioeconomic status, maternal perinatal diseases including maternal fever, diabetes, influenza, maternal certain medication use and alcohol intake were also significantly associated with CHDs. Isolated CHDs and multiple defects have different profiles of risk factors, while subtype of CHDs share common risk factors. Because of differences in methods, these studies are only suggestive. Relatively less information has been reported on noninherited factors that may have an adverse effect on the cardiovascular development, which has made it difficult to create population-based strategies to reduce the burden of illness from CHDs and for couples to choose lifestyles to reduce the risk of delivering a child with CHDs.Bangladesh J Child Health 2017; VOL 41 (1) :40-52

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Prevalence and risk factors of congenital heart defects among live births: a population-based cross-sectional survey in Shaanxi province, Northwestern China

BMC Pediatrics ◽

10.1186/s12887-017-0784-1 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 12

Author(s):

Leilei Pei ◽

Yijun Kang ◽

Yaling Zhao ◽

Hong Yan

Keyword(s):

Risk Factors ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Heart Defects ◽

Population Based ◽

Northwestern China ◽

Shaanxi Province ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Live Births

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Association between advanced paternal age and congenital heart defects: a systematic review and meta-analysis

Human Reproduction ◽

10.1093/humrep/deaa105 ◽

2020 ◽

Vol 35 (9) ◽

pp. 2113-2113

Author(s):

F Joinau-Zoulovits ◽

N Bertille ◽

J F Cohen ◽

B Khoshnood

Keyword(s):

Risk Factors ◽

Congenital Heart Defects ◽

Congenital Malformations ◽

Congenital Heart ◽

Heart Defects ◽

Meta Analysis ◽

Population Based ◽

Risk Of Bias ◽

Paternal Age ◽

Advanced Paternal Age

Abstract STUDY QUESTION Is there an association between advanced paternal age and congenital heart defects (CHD)? SUMMARY ANSWER Advanced paternal age is associated with a 16% increase in the overall odds of CHD. WHAT IS KNOWN ALREADY CHD are the most common congenital malformations. Several risk factors for CHD have been identified in the literature, but the association between advanced paternal age and CHD remains unclear. STUDY DESIGN, SIZE, DURATION We conducted a systematic literature search on MEDLINE and EMBASE (1960–2019) to identify studies assessing the association between advanced paternal age (≥35 years) and the risk of CHD, unrestrictive of language or sample size. We used a combination of Medical Subject Headings (MeSH) terms and free text words such as ‘paternal age’, ‘paternal factors’, ‘father’s age’, ‘parental age’, ‘heart’, ‘cardiac’, ‘cardiovascular’, ‘abnormalities, congenital’, ‘birth defects’, ‘congenital malformations’ and ‘congenital abnormalities’. PARTICIPANTS/MATERIALS, SETTING, METHODS We included observational studies aiming at assessing the association between paternal age and CHD. The included population could be live births, fetal deaths and terminations of pregnancy for fetal anomaly. To be included, studies had to provide either odds ratios (OR) with their 95% confidence interval (CI) or sufficient information to recalculate ORs with 95% CIs per paternal age category. We excluded studies if they had no comparative group and if they were reviews or case reports. Two independent reviewers selected the studies, extracted the data and assessed risk of bias using a modified Newcastle–Ottawa Scale. We used random-effects meta-analysis to produce summary estimates of crude OR. Associations were also tested in subgroups. MAIN RESULTS AND THE ROLE OF CHANCE Of 191 studies identified, we included nine studies in the meta-analysis (9 917 011 participants, including 34 447 CHD), including four population-based studies. Five studies were judged at low risk of bias. Only one population-based study specifically investigated isolated CHD. The risk of CHD was higher with advanced paternal age (summary OR 1.16, 95% CI, 1.07–1.25). Effect sizes were stable in population-based studies and in those with low risk of bias. LIMITATIONS AND REASONS FOR CAUTION The available evidence did not allow to assess (i) the risk of isolated CHD in population-based studies, (ii) the association between paternal age and the risk for specific CHD and (iii) the association between paternal age and CHD after adjustment for other risk factors, such as maternal age. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that advanced paternal age may be a risk factor for CHD. However, because the association is modest in magnitude, its usefulness as a criterion for targeted screening for CHD seems limited. STUDY FUNDING/COMPETING INTEREST(S) None. PROSPERO REGISTRATION NUMBER CRD42019135061.

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