Maternal Risk Factors Predisposing to Congenital Heart Disease | Chapter 12 | Current Trends in Medicine and Medical Research Vol. 3
Background:
Congenital Heart Diseases (CHD) are defined as malformations of the heart and
great vessels that develop in utero which may manifest at birth or later in
childhood. They can be caused by numerous genetic and environmental factors. Genetic factors are nonmodifiable. However, identification of
modifiable environmental risk
factors is important
to develop population
based prevention strategies to reduce the incidence of CHD.
Objectives:
The primary objective of the study was to find an association of the maternal
lifestyles with CHD in new-borns. The secondary outcome of the study was to
identify maternal factors that can be modified for the primary prevention of
CHD.
Materials and
Methods: This
prospective study involved
cardiovascular system examination
of newborns after delivery in term gestations in 1394 singleton
pregnancies. The maternal risk factors considered were age, prepregnancy Body
Mass Index (BMI), consanguineous marriage,
caffeine intake, diabetes, stress and intake of periconceptional Folic
acid tablets.
Results:
In this
study, 22 (1.58%)
out of 1394
pregnancies resulted in
Congenital Heart Defects. Teenage pregnancy (p value= 0.0002),
consanguineous marriage (p value=0.0004), overt diabetes mellitus (p
value=0.0001), caffeine intake (p value=0.0031), prepregnancy BMI>24(p
value=0.0001), maternal stress (p value<0.0001, history of previous
congenital malformations (p value=0.004) and non intake of folic acid tablets
in the first trimester (p value=0.0023 were found to be the most likely risk
factor associated with CHD.
Conclusion:
Community education programmes
should be initiated
in the high-risk
population to prevent teenage pregnancies
and consanguineous marriages. Maternal
counseling for periconceptional control of blood glucose, adequate weight
maintenance, intake of folic acid tablets, avoidance of stress and caffeine is
needed to prevent CHD. The results of numerous studies suggest that in reducing
the incidence of CHD, public health strategy needs to focus on avoidance of
teenage pregnancy and consanguineous marriages. Pregnancy associated with
stress should be monitored more closely.
Prepregnancy maternal BMI,
coffee intake and
folic acid deficiency
have to be corrected. Maternal overt diabetes and
hyperglycemia during pregnancy needs to be screened and managed timely to
reduce the incidence of CHD.
Author(s) Details
Dr. Jayavelan Ramkumar
Department of Cardiothoracic
Surgery, Sri Ramachandra Medical College and University, Chennai-600116, India.
Benjamin M. Sagayaraj
Department of Pediatrics,
Saveetha Medical College, Saveetha University, Chennai-602105, India.
Dr. Nidhi Sharma
Department of Obstetrics and
Gynaecology, Saveetha Medical College, Saveetha University, Chennai-602105,
India.
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