Maternal Risk Factors Predisposing to Congenital Heart Disease: A study in South India

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.

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Maternal Obesity and Diabetes Mellitus as Risk Factors for Congenital Heart Disease in the Offspring

Journal of the American Heart Association ◽

10.1161/jaha.119.011541 ◽

2020 ◽

Vol 9 (8) ◽

Cited By ~ 2

Author(s):

Emmi Helle ◽

James R. Priest

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

At Risk ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Maternal Obesity ◽

World Population ◽

Maternal Risk ◽

Obesity And Diabetes

Abstract Congenital heart disease (CHD) is the most common anatomical malformation occurring live‐born infants and an increasing cause of morbidity and mortality across the lifespan and throughout the world. Population‐based observations have long described associations between maternal cardiometabolic disorders and the risk of CHD in the offspring. Here we review the epidemiological evidence and clinical observations relating maternal obesity and diabetes mellitus to the risk of CHD offspring with particular attention to mechanistic models of maternal‐fetal risk transmission and first trimester disturbances of fetal cardiac development. A deeper understanding of maternal risk factors holds the potential to improve both prenatal detection of CHD by identifying at‐risk pregnancies, along with primary prevention of disease by improving preconception and prenatal treatment of at‐risk mothers.

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Risk Factors for Gross Motor Dysfunction in Infants With Congenital Heart Disease

Infants & Young Children ◽

10.1097/iyc.0b013e3182176274 ◽

2011 ◽

Vol 24 (3) ◽

pp. 246-258 ◽

Cited By ~ 3

Author(s):

Suzanne H. Long ◽

Bev J. Eldridge ◽

Mary P. Galea ◽

Susan R. Harris

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Motor Dysfunction ◽

Gross Motor

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Nineteen Years of Adult Congenital Heart Surgery in a Single Center

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116682454 ◽

2017 ◽

Vol 8 (2) ◽

pp. 182-188

Author(s):

Madurra Perinpanayagam ◽

Signe H. Larsen ◽

Kristian Emmertsen ◽

Marianne B. Møller ◽

Vibeke E. Hjortdal

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Cardiac Surgery ◽

Heart Disease ◽

Postoperative Complications ◽

Adverse Events ◽

Congenital Heart ◽

Postoperative Bleeding ◽

Registration System ◽

Growing Population

Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

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Socio-hygienic and biomedical risk factors for congenital heart disease in children

Yakut Medical Journal ◽

10.25789/ymj.2018.62.37 ◽

2018 ◽

pp. 116-119

Author(s):

T.I. Nelunova ◽

T.E. Burtseva ◽

V.G. Chasnyk ◽

S.A. Evseeva

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart

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Chylothorax after surgery on congenital heart disease in newborns and infants -risk factors and efficacy of MCT-diet

Journal of Cardiothoracic Surgery ◽

10.1186/1749-8090-5-127 ◽

2010 ◽

Vol 5 (1) ◽

Cited By ~ 43

Author(s):

Eva S Biewer ◽

Christoph Zürn ◽

Raoul Arnold ◽

Martin Glöckler ◽

Jürgen Schulte-Mönting ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart

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Risk factors for nosocomial infections after cardiac surgery in newborns with congenital heart disease

Pediatrics & Neonatology ◽

10.1016/j.pedneo.2018.07.009 ◽

2018 ◽

Vol 59 (4) ◽

pp. 327-328 ◽

Cited By ~ 1

Author(s):

Pei-Lan Shao

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Cardiac Surgery ◽

Heart Disease ◽

Nosocomial Infections ◽

Congenital Heart

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Environmental Risk Factors and Congenital Heart Disease: An Umbrella Review of 165 Systematic Reviews and Meta-Analyses With More Than 120 Million Participants

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.640729 ◽

2021 ◽

Vol 8 ◽

Author(s):

Tie-Ning Zhang ◽

Qi-Jun Wu ◽

Ya-Shu Liu ◽

Jia-Le Lv ◽

Hui Sun ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Environmental Factors ◽

Congenital Heart ◽

Prediction Intervals ◽

Umbrella Review ◽

Wide Range ◽

Null Value ◽

Meta Analyses

Background: The etiology of congenital heart disease (CHD) has been extensively studied in the past decades. Therefore, it is critical to clarify clear hierarchies of evidence between types of environmental factors and CHD.Methods: Electronic searches in PubMed, Embase, Web of Science, Cochrane database were conducted from inception to April 20, 2020 for meta-analyses investigating the aforementioned topic.Results: Overall, 41 studies including a total of 165 meta-analyses of different environmental factors and CHD were examined, covering a wide range of risk factors. The summary random effects estimates were significant at P < 0.05 in 63 meta-analyses (38%), and 15 associations (9%) were significant at P < 10−6. Of these meta-analyses, eventually one risk factor (severe obesity; relative risk: 1.38, 95% confidence interval: 1.30–1.47) had significant summary associations at P < 10−6, included more than 1,000 cases, had 95% prediction intervals excluding the null value, and were not suggestive of large heterogeneity (I2 < 50%), small-study effects (P-value for Egger's test > 0.10), or excess significance (P > 0.10). Eight associations (5%) (including maternal lithium exposure, maternal obesity, maternal alcohol consumption, and maternal fever) had results that were significant at P < 10−6, included more than 1,000 cases, and had 95% prediction intervals excluding the null value (highly suggestive).Conclusion: This umbrella review shows that many environmental factors have substantial evidence in relation to the risk of developing CHD. More and better-designed studies are needed to establish robust evidence between environmental factors and CHD.Systematic Review Registration: [PROSPERO], identifier [CRD42020193381].

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