Risk factors for congenital heart disease: The Baby Hearts Study, a population-based case-control study.
Adult
Case-Control Studies
Diabetes, Gestational
/ pathology
Diet
Female
Folic Acid
/ pharmacology
Heart Defects, Congenital
/ epidemiology
Humans
Infant
Maternal Behavior
Mental Health
Obesity
/ complications
Pregnancy
Probability
Reproduction
Risk Factors
Smoking
/ adverse effects
Stress, Psychological
/ complications
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
18
06
2019
accepted:
02
01
2020
entrez:
25
2
2020
pubmed:
25
2
2020
medline:
23
4
2020
Statut:
epublish
Résumé
We investigated the role of maternal environmental factors in the aetiology of congenital heart disease (CHD). A population-based case-control study (242 CHD cases, 966 controls) was conducted using an iPad questionnaire for mother with linkage to maternity and first trimester prescription records. Risk of CHD was associated with low maternal education (OR adjusted for confounders 1.59; 95% confidence interval [CI], 1.02-2.49), pregestational diabetes (OR 4.04; 95% CI 1.00-16.28), self-reported maternal clotting disorders (adjOR 8.55, 95%CI 1.51-48.44), prescriptions for the anticlotting medication enoxaparin (adjOR 3.22, 95%CI 1.01-10.22) and self-reported vaginal infections (adjOR 1.69, 95%CI 1.01-2.80). There was no strong support for the hypothesis that periconceptional folic acid supplements have a protective effect, but there was a protective effect of frequent consumption of folate rich fruits (adjOR 0.64, 95%CI 0.47-0.89). Compared to the most common pre-pregnancy dietary pattern, CHD risk was associated with a poor diet low in fruit and vegetables (adjOR 1.56, 95%CI 1.05-2.34). Mothers of cases reported more pregnancy related stress (adjOR 1.69; 95% CI 1.22-2.34) and multiple stressors (adjOR 1.94, 95%CI 0.83-4.53). We found no supportive evidence for CHD risk being associated with obesity, smoking, depression or antidepressant use in this population. Our findings add to the previous evidence base to show potential for public health approaches to help prevent CHD in future by modifying environmental factors. Independent confirmation should be sought regarding elevated CHD risk associated with maternal blood clotting disorders and their treatment, since we are the first to report this.
Identifiants
pubmed: 32092068
doi: 10.1371/journal.pone.0227908
pii: PONE-D-19-17236
pmc: PMC7039413
doi:
Substances chimiques
Folic Acid
935E97BOY8
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0227908Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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