Maternal Risk Factors and its Relation to Congenital Heart Disease
Keywords:
Maternal hypertension, Congenital heart disease, neonatal, atrial septal defectsAbstract
Background
Congenital heart disease (CHD) remains a major cause of neonatal morbidity and mortality, particularly in resource-constrained settings . Maternal risk factors such as hypertension, diabetes mellitus (DM), thyroid disorders, and familial predispositions have been linked to increased incidence of CHD in offspring. However, the magnitude of these associations and their relevance to specific populations require further study.
Aim
This cross-sectional study investigated the prevalence of maternal risk factors and their relationship to CHD among neonates admitted to the Neonatal Intensive Care Unit (NICU) at Baghdad Teaching Hospital.
Methods
Over a six-month period, 3192 newborn was delivered and 673 neonates admitted to the NICU were screened for CHD via clinical examination and echocardiography . Maternal medical records and structured interviews captured data on hypertension, DM, thyroid disorders, other chronic conditions (including systemic lupus erythematosus, idiopathic thrombocytopenic purpura, and asthma), maternal congenital heart disease, a prior sibling with CHD, and maternal pulmonary hypertension . Multivariate logistic regression was used to identify independent predictors of neonatal CHD, adjusting for potential confounders such as maternal age, socioeconomic status, and antenatal care attendance.
Results
A total of 165 neonates (24.5%) were diagnosed with CHD. Maternal hypertension (adjusted odds ratio [aOR]: 2.12, 95% CI: 1.41–3.19) and DM (aOR: 1.75, 95% CI: 1.15–2.67) emerged as strong independent risk factors for CHD (p<0.05). Additionally, neonates with a prior sibling affected by CHD demonstrated significantly higher odds of CHD (aOR: 2.56, 95% CI: 1.18–5.50). Thyroid disorders, chronic autoimmune/respiratory conditions, maternal congenital heart disease, and maternal pulmonary hypertension showed elevated risk in univariate analyses but lost statistical significance in the adjusted models (p>0.05).
Conclusion
Maternal hypertension, DM, and a family history of CHD in a prior sibling constitute significant risk factors for CHD in neonates. These findings highlight the importance of targeted prenatal care, including strict control of chronic conditions and enhanced fetal cardiac monitoring for at-risk mothers. Future research should explore genetic contributions and the complex interactions among multiple maternal risk factors to improve prevention and early detection strategies.
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