scholarly journals First-Trimester Maternal Folic Acid Supplementation Modifies the Effects of Risk Factors Exposures on Congenital Heart Disease in Offspring

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 724
Author(s):  
Yanji Qu ◽  
Shao Lin ◽  
Michael S. Bloom ◽  
Ximeng Wang ◽  
Zhiqiang Nie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Folic Acid ◽  
Congenital Heart ◽  
First Trimester ◽  
Folic Acid Supplementation ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Maternal Risk Factor

This study aimed to examine effect modification of maternal risk factor exposures and congenital heart disease (CHD) by maternal folic acid supplementation (FAS)/non-FAS. We included 8379 CHD cases and 6918 CHD-free controls from 40 clinical centers in Guangdong Province, Southern China, 2004–2016. Controls were randomly chosen from malformation-free fetuses and infants and frequency matched to the echocardiogram-confirmed cases by enrollment hospital and year of birth. We used multiple regression models to evaluate interactions between FAS/non-FAS and risk factors on CHDs and major CHD categories, adjusted for confounding variables. We detected statistically significant additive and multiplicative interactions between maternal FAS/non-FAS and first-trimester fever, viral infection, and threatened abortion on CHDs. An additive interaction on CHDs was also identified between non-FAS and living in a newly renovated home. We observed a statistically significant dose-response relationship between non-FAS and a greater number of maternal risk factors on CHDs. Non-FAS and maternal risk factors interacted additively on multiple critical CHDs, conotruncal defects, and right ventricular outflow tract obstruction. Maternal risk factor exposures may have differential associations with CHD risk in offspring, according to FAS. These findings may inform the design of targeted interventions to prevent CHDs in highly susceptible population groups.

Arterial disease in the young

ESC CardioMed ◽  
2018 ◽  
pp. 775-778
Author(s):  
Marietta Charakida ◽  
John Deanfield
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Congenital Heart ◽  
Cardiovascular Health ◽  
Adult Population ◽  
Arterial Disease ◽  
Ideal Cardiovascular Health ◽  
Reduce Risk ◽  
Reduce Risk Factor

The growing adult population with congenital heart disease (CHD) are getting older and their clinical presentation and outcomes are likely to be determined not only by their underlying CHD, but also by the development of acquired cardiovascular diseases such as atherosclerosis. This begins in childhood. The adult CHD population have multiple cardiovascular risk factors, as found in the general population, including obesity, smoking, and sedentary behaviour. Adults with complex congenital heart circulation are likely to be particularly vulnerable to the development of acquired arterial disease. Maintenance of ‘ideal cardiovascular health’ from childhood, is a key target, as leveraged gains can be achieved by early intervention to reduce risk factor exposure.

scholarly journals P1582 Outcomes, predictors and treatment of intraatrial reentrant tachycardias in Adult with Congenital Heart Disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Cambronero Cortinas ◽  
P Moratalla-Haro ◽  
A E Gonzalez-Garcia ◽  
P Avila-Alonso ◽  
M Bret-Zurita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Tricuspid Regurgitation ◽  
Cardiovascular Events ◽  
Congenital Heart ◽  
Late Complication ◽  
Systolic Pressure ◽  
First Choice

Abstract Introduction and objectives Atrial tachycardia (AT) is a major late complication in congenital heart disease (CHD) after surgery. These arrhythmias arise between areas of anatomical barriers or in fibrotic tissue/scars. In our study we examined the clinical predictors of AT. Methods A retrospective study of cases and controls in adult patients with CHD was performed. We have included consecutively 71 patients with AT and 71 controls matched by gender, age and type of CHD located in the same database. Medical records, electrocardiograms and echocardiograms were reviewed. Multivariate analysis of the risk factor (logistic regression) and analysis of adverse cardiovascular events (Kaplan-Meier) were performed. Results Systolic pressure of subpulmonary ventricle ≥40mmHg (HR:7, 95%CI:2.4-18, p = 0.001), right atrium (RA) dilatation≥21cm2 (HR:3, 95%CI:1.2-7.6, p = 0.005), significant tricuspid regurgitation (HR:4, 95%CI:1.3-10, p = 0.018) were identified as main risk factors for AT. Patients with AT had worse outcomes with more major adverse cardiovascular events (86% vs 14%, P = 0.006), and a 58% free survival events compared to 98% of patients without AT at 8 years of follow-up (p = 0.01). The treatment of the first episode of AT was electrical cardioversion (38%), pharmacological cardioversion (13%), heart rate control (20%). Antiarrhythmic treatment was not been given in 30% of the patients 73% of them had percutaneous ablation as first choice treatment. Ablation was performed in 40 pacientes and 6 patients have recurrences. In total, 24 patients have recurrences of AT. Previous Maze (OR 9 (IC al 95% 1.5, 50), p = 0.016) and surgical paliative shunt (OR 21 (IC al 95% 2.3,192), p = 0.007) were identified as main risk factor for AT recurrences. Conclusions The main risk factors identified for AT were RA dilatation, raised systolic pressure of subpulmonary ventricle and significant tricuspid regurgitation. The main risk factors for AT recurrences were previous Maze and surgical paliative shunt. Early treatment of these arrhythmic problems is mandatory in order to improve the prognosis in this group of patients. Abstract P1582 Figure. Central illustration of AT in CHD

Maternal risk factors for congenital heart defects in infants with Down syndrome from Western Mexico

2019 ◽  
Author(s):  
Jorge Román Corona‐Rivera ◽  
Rafael Nieto‐García ◽  
Andrea S. Gutiérrez‐Chávez ◽  
Lucina Bobadilla‐Morales ◽  
Izabel M. Rios‐Flores ◽  
...  
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Western Mexico

Abnormal folic acid-homocysteine metabolism as maternal risk factors for Down syndrome in Japan

2004 ◽  
Vol 43 (5) ◽  
pp. 285-287 ◽  
Author(s):  
Noboru Takamura ◽  
Tatsuro Kondoh ◽  
Syohei Ohgi ◽  
Kokichi Arisawa ◽  
Mariko Mine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Folic Acid ◽  
Maternal Risk Factors ◽  
Maternal Risk

scholarly journals First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Yanji Qu ◽  
Shao Lin ◽  
Jian Zhuang ◽  
Michael S. Bloom ◽  
Maggie Smith ◽  
...  
Keyword(s):  
Folic Acid ◽  
Congenital Heart ◽  
Case Control Study ◽  
First Trimester ◽  
Folic Acid Supplementation ◽  
Case Control ◽  
Childbearing Age ◽  
Acid Supplementation ◽  
Multivitamin Use ◽  
Control Study

Background Maternal folic acid supplementation (FAS) reduces the risk of neural tube defects in offspring. However, its effect on congenital heart disease (CHDs), especially on the severe ones remains uncertain. This study aimed to assess the individual and joint effect of first‐trimester maternal FAS and multivitamin use on CHDs in offspring. Methods and Results This is a case‐control study including 8379 confirmed CHD cases and 6918 controls from 40 healthcare centers of 21 cities in Guangdong Province, China. Adjusted odds ratios (aORs) of FAS and multivitamin use between CHD cases (overall and specific CHD phenotypes) and controls were calculated by controlling for parental confounders. The multiplicative interaction effect of FAS and multivitamin use on CHDs was estimated. A significantly protective association was detected between first‐trimester maternal FAS and CHDs among offspring (aOR, 0.69; 95% CI, 0.62–0.76), but not for multivitamin use alone (aOR, 1.42; 95% CI, 0.73–2.78). There was no interaction between FAS and multivitamin use on CHDs ( P =0.292). Most CHD phenotypes benefited from FAS (aORs ranged from 0.03–0.85), especially the most severe categories (ie, multiple critical CHDs [aOR, 0.16; 95% CI, 0.12–0.22]) and phenotypes (ie, single ventricle [aOR, 0.03; 95% CI, 0.004–0.21]). Conclusions First‐trimester maternal FAS, but not multivitamin use, was substantially associated with lower risk of CHDs, and the association was strongest for the most severe CHD phenotypes. We recommend that women of childbearing age should supplement with folic acid as early as possible, ensuring coverage of the critical window for fetal heart development to prevent CHDs.

scholarly journals Incidence and risk factors of congenital heart disease in Qingdao: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao Jin ◽  
Wei Ni ◽  
Guolan Wang ◽  
Qin Wu ◽  
Jun Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Logistic Regression ◽  
Cohort Study ◽  
Heart Disease ◽  
Congenital Heart ◽  
First Trimester ◽  
Chd Risk ◽  
Positive Rate ◽  
Chd Risk Factors

Abstract Background Many studies have been conducted to assess the incidence of congenital heart disease (CHD). However, results were greatly inconsistent among these studies with a broad range of findings. Methods A prospective census-based cohort study was conducted in Qingdao, China, from August 1, 2018 to April 30, 2019. All of the local registered pregnant women were continuously investigated and followed from 15 to 20 weeks of gestation to delivery, tracking the CHD cases in both the fetal and neonatal stages. A logistic regression model was applied to assess the association between CHD and possible risk factors. Results The positive rate of prenatal CHD screening was 14.36 per 1000 fetuses and the incidence of CHD was 9.38 per 1000 live births. Results from logistic regression indicated that, living in the countryside (odds ratio, (OR): 0.771; 95% confidence interval, (CI): 0.628–0.946) and having a childbearing history (OR: 0.802; 95%CI: 0.676–0.951) were negatively associated with CHD. However, twin pregnancy (OR: 1.957, 95% CI: 1.245–3.076), illness in the first trimester (OR: 1.306; 95% CI: 1.048–1.628), a family history of CHD (OR: 7.156; 95% CI: 3.293–15.552), and having a child with a birth defect (OR: 2.086; 95% CI: 1.167–3.731) were positively associated with CHD. Conclusion CHD is a serious health problem in Qingdao. The CHD incidence found in this study was similar to existing research. The positive rate of prenatal CHD screening was higher than the incidence of neonatal CHD. Moreover, CHD risk factors were identified in our study, and our findings may have great implications for formation CHD intervention strategies.

Sign in / Sign up

Export Citation Format

Share Document