Associated Factors for Prenatally Diagnosed Fetal Congenital Heart Diseases

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2023 Jan 28

PMID 36707754

Authors

Yanping Ruan

Zan Xie

Xiaowei Liu

Yihua He

Affiliations

Soon will be listed here.

Abstract

Objective: Current studies have suggested that fetal congenital heart diseases (CHDs) are caused by various factors. However, few data in this field is available in China. This study aimed to detect associated factors of prenatally diagnosed fetal CHD in a large sample in China.

Study Design: Pregnant women who underwent fetal echocardiography were recruited in our hospital between May 2018 and September 2019. The maternal sociodemographic and lifestyle characteristics and some fetal factors were obtained. We used forward stepwise logistic regression analysis to assess risk of fetal CHD associated with various factors.

Results: A total of 5024 subjects were enrolled, of whom 875 had CHD fetuses. Among the fetal CHD group (N = 875), critical CHDs account for 27%, of which Tetralogy of Fallot is the most (7.1%), followed by coarctation of aorta (4.0%), double-outlet right ventricle (2.9%). The forward stepwise logistic regression models revealed that history of spontaneous abortion (OR = 1.59, 95% CI 1.33-1.91, P = 0.000), upper respiratory tract infection during early pregnancy (OR = 1.30, 95% CI 1.04-1.62, P = 0.020), mental stress during early pregnancy (OR = 2.37, 95% CI 1.15-4.91, P = 0.020), single umbilical artery (OR = 2.30, 95% CI 1.18-4.51, P = 0.015), and paternal smoking (OR = 1.21, 95% CI 1.02-1.44, P = 0.027) are positively associated with an increased risk of fetal CHD.

Conclusion: We identified several factors positively associated with fetal CHD. These findings suggest that it is important to strengthen healthcare and prenatal counseling for women with these factors.

References

Zhao Q, Liu F, Wu L, Ma X, Niu C, Huang G . Prevalence of Congenital Heart Disease at Live Birth in China. J Pediatr. 2018; 204:53-58. DOI: 10.1016/j.jpeds.2018.08.040. View

International Society of Ultrasound in Obstetrics and Gynecology , Carvalho J, Allan L, Chaoui R, Copel J, DeVore G . ISUOG Practice Guidelines (updated): sonographic screening examination of the fetal heart. Ultrasound Obstet Gynecol. 2013; 41(3):348-59. DOI: 10.1002/uog.12403. View

Nashed L, ONeil J . The impact of socioeconomic status and race on the outcomes of congenital heart disease. Curr Opin Cardiol. 2021; 37(1):86-90. DOI: 10.1097/HCO.0000000000000928. View

Tennant P, Pearce M, Bythell M, Rankin J . 20-year survival of children born with congenital anomalies: a population-based study. Lancet. 2010; 375(9715):649-56. DOI: 10.1016/S0140-6736(09)61922-X. View

Karatza A, Giannakopoulos I, Dassios T, Belavgenis G, Mantagos S, Varvarigou A . Periconceptional tobacco smoking and isolated congenital heart defects in the neonatal period. Int J Cardiol. 2009; 148(3):295-9. DOI: 10.1016/j.ijcard.2009.11.008. View

Rogers J . Tobacco and pregnancy. Reprod Toxicol. 2009; 28(2):152-60. DOI: 10.1016/j.reprotox.2009.03.012. View

Robinson R, Stavsky M, Sade M, Krymko H, Slanovic L, Novack V . Risk factors for congenital heart defects in two populations residing in the same geographic area: a long-term population-based study, Southern Israel. Cardiol Young. 2019; 29(8):1040-1044. DOI: 10.1017/S1047951119001409. View

Donofrio M, Moon-Grady A, Hornberger L, Copel J, Sklansky M, Abuhamad A . Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 2014; 129(21):2183-242. DOI: 10.1161/01.cir.0000437597.44550.5d. View

Tikkanen J, Heinonen O . Congenital heart disease in the offspring and maternal habits and home exposures during pregnancy. Teratology. 1992; 46(5):447-54. DOI: 10.1002/tera.1420460509. View

10.

Thummala M, Raju T, Langenberg P . Isolated single umbilical artery anomaly and the risk for congenital malformations: a meta-analysis. J Pediatr Surg. 1998; 33(4):580-5. DOI: 10.1016/s0022-3468(98)90320-7. View

11.

Mahle W, Newburger J, Matherne G, Smith F, Hoke T, Koppel R . Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation. 2009; 120(5):447-58. DOI: 10.1161/CIRCULATIONAHA.109.192576. View

12.

Grines C, Klein A, Bauser-Heaton H, Alkhouli M, Katukuri N, Aggarwal V . Racial and ethnic disparities in coronary, vascular, structural, and congenital heart disease. Catheter Cardiovasc Interv. 2021; 98(2):277-294. DOI: 10.1002/ccd.29745. View

13.

Chou H, Chiou M, Liang F, Chen L, Lu T, Li C . Association of maternal chronic disease with risk of congenital heart disease in offspring. CMAJ. 2016; 188(17-18):E438-E446. PMC: 5135520. DOI: 10.1503/cmaj.160061. View

14.

Woods S, Raju U . Maternal smoking and the risk of congenital birth defects: a cohort study. J Am Board Fam Pract. 2001; 14(5):330-4. View

15.

Shi M, Wehby G, Murray J . Review on genetic variants and maternal smoking in the etiology of oral clefts and other birth defects. Birth Defects Res C Embryo Today. 2008; 84(1):16-29. PMC: 2570345. DOI: 10.1002/bdrc.20117. View

16.

Xia Y, Zhao K, Zhao A, Zhu J, Hong H, Wang Y . Associations of maternal upper respiratory tract infection/influenza during early pregnancy with congenital heart disease in offspring: evidence from a case-control study and meta-analysis. BMC Cardiovasc Disord. 2019; 19(1):277. PMC: 6889668. DOI: 10.1186/s12872-019-1206-0. View

17.

Chou F, Chakradhar R, Ghimire L . Socioeconomic and racial disparities in the prevalence of congenital heart disease in infants of diabetic mothers. J Matern Fetal Neonatal Med. 2019; 34(24):4167-4170. DOI: 10.1080/14767058.2019.1702955. View

18.

Shi H, Enriquez A, Rapadas M, Martin E, Wang R, Moreau J . NAD Deficiency, Congenital Malformations, and Niacin Supplementation. N Engl J Med. 2017; 377(6):544-552. DOI: 10.1056/NEJMoa1616361. View

19.

Bruneau B . The developmental genetics of congenital heart disease. Nature. 2008; 451(7181):943-8. DOI: 10.1038/nature06801. View

20.

Jenkins K, Correa A, Feinstein J, Botto L, Britt A, Daniels S . Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation. 2007; 115(23):2995-3014. DOI: 10.1161/CIRCULATIONAHA.106.183216. View