Document Type : Original Article(s)
Authors
1 Associate Professor, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: Improving knowledge towards risk factors for congenital heart disease (CHD) is important because of its high mortality and morbidity and trying for prevention of occurrence of CHD.METHODS: This case-control study was conducted on a total of 898 children with their mothers, who referred to the Clinic of Pediatric Cardiology of School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, during the years of 2014 to 2016. Cases comprised of 464 children with CHD diagnosed by echocardiography and controls were 434 sex- and age-matched children without any evidence of CHD, who were admitted for a heart check-up at the same study period and in similar conditions. The children's parents completed check lists for collecting demographic characteristics, family history of CHD, history of obesity in mother, history of abortion and diseases in mother, use of medicine during pregnancy, exposure to teratogens during pregnancy, and children characteristics such as birth height and birth weight, etc.RESULTS: Based on the results of data analyses with multiple logistic regression model [odds ratio (OR) with 95% confidence interval (CI)], history of obesity in mother before pregnancy, history of abortion, parental consanguinity, exposure to cigarette smoke during pregnancy, exposures to teratogens in the first trimester of the pregnancy, and use of medicine during pregnancy were associated with an increased odds of CHDs.CONCLUSION: Results of this study emphasizes the use of policies that enhance pre-marital counseling, regular counseling during pregnancy, treatment of mothers' disease, and enhancing knowledge of women of childbearing age about exposure to certain teratogens for controlling risk factors of CHD.
Keywords
- Ren YY, Li XT, Gui YH, Yan YL, Chang C, Zhang JH, et al. Evaluation of the prenatal screening mode for fetal congenital heart diseases by ultrasound. Zhonghua Fu Chan Ke Za Zhi 2008; 43(8): 589-92.
- Lage K, Greenway SC, Rosenfeld JA, Wakimoto H, Gorham JM, Segre AV, et al. Genetic and environmental risk factors in congenital heart disease functionally converge in protein networks driving heart development. Proc Natl Acad Sci U S A 2012; 109(35): 14035-40.
- Wong P, Denburg A, Dave M, Levin L, Morinis JO, Suleman S, et al. Early life environment and social determinants of cardiac health in children with congenital heart disease. Paediatr Child Health 2018; 23(2): 92-5.
- Sun R, Liu M, Lu L, Zheng Y, Zhang P. Congenital heart disease: Causes, diagnosis, symptoms, and treatments. Cell Biochem Biophys 2015; 72(3): 857-60.
- Liang Q, Gong W, Zheng D, Zhong R, Wen Y, Wang X. The influence of maternal exposure history to virus and medicine during pregnancy on congenital heart defects of fetus. Environ Sci Pollut Res Int 2017; 24(6): 5628-32.
- Tan MJ. A case-control study on the environmental factors and children congenital heart disease during early pregnancy. J Environ Health 2006; 23: 427-30.
- Kallen B, Otterblad Olausson P. Antidepressant drugs during pregnancy and infant congenital heart defect. Reprod Toxicol 2006; 21(3): 221-2.
- Simeone RM, Devine OJ, Marcinkevage JA, Gilboa SM, Razzaghi H, Bardenheier BH, et al. Diabetes and congenital heart defects: A systematic review, meta-analysis, and modeling project. Am J Prev Med 2015; 48(2): 195-204.
- Kim MA, Lee YS, Yee NH, Choi JS, Choi JY, Seo K. Prevalence of congenital heart defects associated with Down syndrome in Korea. J Korean Med Sci 2014; 29(11): 1544-9.
- Bondy C. Congenital cardiovascular defects in Monosomy X or Turner Syndrome. In: Muenke M, Kruszka PS, Sable CA, Belmont JW, Editors. Congenital heart disease: Molecular genetics, principles of diagnosis and treatment. Basel, Switzerland: Karger Medical and Scientific Publishers; 2015. p. 91-9.
- Qin YF, Xie CH, Yang JB, Wu DW, Shao J, Zhao ZY. Relationship between 22q11 microdeletion syndrome and congenital heart disease. Zhonghua Xin Xue Guan Bing Za Zhi 2011; 39(7): 631-5.
- Wolf M, Basson CT. The molecular genetics of congenital heart disease: A review of recent developments. Curr Opin Cardiol 2010; 25(3): 192-7.
- Weismann CG, Gelb BD. The genetics of congenital heart disease: A review of recent developments. Curr Opin Cardiol 2007; 22(3): 200-6.
- Vener DF, Tirotta CF, Andropoulos D, Barach P. Anaesthetic complications associated with the treatment of patients with congenital cardiac disease: Consensus definitions from the multi-societal database committee for pediatric and congenital heart disease. Cardiol Young 2008; 18(Suppl 2): 271-81.
- Pasquali SK, He X, Jacobs ML, Shah SS, Peterson ED, Gaies MG, et al. Excess costs associated with complications and prolonged length of stay after congenital heart surgery. Ann Thorac Surg 2014; 98(5): 1660-6.
- Brite J, Laughon SK, Troendle J, Mills J. Maternal overweight and obesity and risk of congenital heart defects in offspring. Int J Obes (Lond) 2014; 38(6): 878-82.
- Persson M, Cnattingius S, Villamor E, Soderling J, Pasternak B, Stephansson O, et al. Risk of major congenital malformations in relation to maternal overweight and obesity severity: Cohort study of 1.2 million singletons. BMJ 2017; 357: j2563.
- Kmietowicz Z. Risk of major birth defects rises with severity of mother's overweight. BMJ 2017; 357: j2911.
- Grattan MJ, Thomas DS, Hornberger LK, Hamilton RM, Midodzi WK, Vohra S. Maternal hypothyroidism may be associated with CHD in offspring. Cardiol Young 2015; 25(7): 1247-53.
- Naghavi-Behzad M, Alizadeh M, Azami S, Foroughifar S, Ghasempour-Dabbaghi K, Karzad N, et al. Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran. J Cardiovasc Thorac Res 2013; 5(1): 5-9.
- Feng Y, Wang S, Zhao L, Yu D, Hu L, Mo X. Maternal reproductive history and the risk of congenital heart defects in offspring: A systematic review and meta-analysis. Pediatr Cardiol 2015; 36(2): 253-63.
- Taksande A, Vilhekar K, Chaturvedi P, Jain M. Congenital malformations at birth in Central India: A rural medical college hospital based data. Indian J Hum Genet 2010; 16(3): 159-63.
- Ul Hag F, Jalil F, Hashmi S, Jumani MI, Imdad A, Jabeen M, et al. Risk factors predisposing to congenital heart defects. Ann Pediatr Cardiol 2011; 4(2): 117-21.
- Nicoll R. Environmental contaminants and congenital heart defects: A re-evaluation of the evidence. Int J Environ Res Public Health 2018; 15(10).
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