Abstract
This paper reports the results of a case-control study of major congenital heart defects (CHD) in Sweden. During the period 1981–1986, 1,324 such cases were identified and 2,648 controls were selected. Some common maternal characteristics and exposures were studied using information from prospectively collected data. Possible associations with CHD were found for previous perinatal death, maternal diabetes, epilepsy, hydramnios and disproportion between fetus and pelvis. More specific associations were observed between previous spontaneous abortion, epilepsy, hydramnios and truncus anomalies and between diabetes and septal anomalies. However, no associations were found with involuntary childlessness, contraceptive use, or smoking.
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Abbreviations
- ASD:
-
atrial septal defect
- CHD:
-
congenital heart defect
- CI:
-
confidence interval
- CoA:
-
coarctation of the aorta
- DORY:
-
double outlet right ventricle
- ECD:
-
endocardial cushion defect
- HLHS:
-
hypoplastic left heart syndrome
- IUD:
-
intrauterine device
- LMP:
-
last menstrual period
- OC:
-
oral contraceptive
- OR:
-
odds ratio
- PDA:
-
patent ductus arteriosus
- TGV:
-
transposition of the great vessels
- VSD:
-
ventricular septal defect
References
BossiL. (1983): Fetal effects of anticonvulsants. In: MorselliP.L., PippengerC.E., PenryJ.K. eds.. Antiepileptic drug therapy in pediatrics - New York: Raven Press: 37–64.
CarlgrenL.E., EricsonA. and KällénB. (1987): Monitoring of congenital cardiac defects - Pediatr. Cardiol. 8: 247–256.
CnattingiusS., EricsonA., GunnarskogJ. and KällénB. (1990): A quality study of a medical birth registry -Scand. J. Soc. Med. 18: 143–148.
DanskyL.Y. and FinnellR.H. (1991): Parental epilepsy, anticonvulsant drugs and reproductive outcome: epidemiologic and experimental findings spanning three decades; 2: Human studies - Reprod. Toxicol. 5(4): 301–335.
FedrickJ., AlbermanE.D. and GoldsteinH. (1971): Possible teratogenic effect of cigarette smoking -Nature 231: 529–530.
Ferencz C., Matanoski G.M., Wilson P.D., Rubin J., Neill C.A. and Gutberlet R. (1979): Maternal hormone therapy and congenital heart disease - Teratology 19(2): 26A.
FraserF.C. (1976): The multifactorial/threshold concept - Uses and misuses - Teratology 14: 267–280.
GhaziH.A., SpielbergerC. and KällénB. (1991): Delivery outcome after infertility - a registry study -Fertil Steril 55: 726–732.
HeinonenO.P., SloaneD., MonsonR.R., HookE.B. and ShapiroS. (1977): Cardiovascular birth defects and antenatal exposure to female sex hormones - N. Engl. J. Med. 296: 67–70.
HendricksS.K., ConwayL., WangK., KomarniskiC., MackL.A., CyrD. and UhrichS. (1991): Diagnosis of polyhydramnios in early gestation: indication for prenatal diagnosis? - Prenatal diagnosis 11: 649–654.
JacobyH.E. and CharlesD. (1966): Clinical conditions associated with hydramnios - Am. J. Obstet. Gynecol. 94(7): 910–919.
JanerichD.T., DuganJ.M., StandfastS.J. and StriteL. (1977): Congenital heart disease and prenatal exposure to exogenous sex hormones - Brit. Med. J. 1: 1058–1060.
Källén B. (1988): Epidemiological techniques. In: Epidemiology of human reproduction - CRC Press: 72–73.
KällénB. and WinbergJ. (1968): A Swedish register of congenital malformations. Experience with continuous registration during 2 years with special reference to multiple malformations - Pediatrics 41: 765–776.
LemonsJ.A., VargasP. and DelaneyJ.J. (1981): Infant of the diabetic mother: Review of 225 cases - Obstet Gynecol. 57: 187–192.
LevyF.P., CohenA. and FraserF.C. (1973): Hormone treatment during pregnancy and congenital heart defects - Lancet 1: 611.
LunellN.O. (1986): Obstetric complications in diabetic pregnancy - Acta Endocrinologica Supplementum277: 117–121.
MantelN. and HaenszelW. (1959): Statistical aspects of the analysis of data from retrospective studies of disease - J. Nat. Can. Inst. 22: 719–748.
MiettinenO.S. (1969): Individual matching with multiple controls in the case of all-or-none responses -Biometrics 25: 339–355.
MiettinenO.S. (1974): Simple interval estimation of risk ratio - Am. J. Epidemiol. 100: 515–516.
NoraJ.J. (1968): Multifactorial inheritance hypothesis for the etiology of congenital heart disease - Circulation 38: 604–617.
NoraJ.J. and NoraA.H. (1973): Birth defects and oral contraceptives - Lancet 1: 941–942.
NoraJ.J. and NoraA.H. (1973): Preliminary evidence for a possible association between oral contraceptives and birth defects - Teratology 7: A24.
NoraJ.J. and NoraA.H. (1977): Contraceptive hormones and congenital heart disease - Teratology 15: 331.
PedersenL.M., TygstrupI. and PedersenJ. (1964): Congenital malformations in newborn infants of diabetic women. Correlation with maternal diabetic vascular complications - Lancet 1: 1124–1126.
Pexieder T. (1986): Teratogens. In: Genetics of cardiovascular disease. Eds. Pierpont M.E. and Moller J.H.: 25–68.
PradatP. (1992): The epidemiology of major congenital heart defects in Sweden, 1981–1986 - J. Epidemiol. Community Health 46: 211–215.
RowlandT.W., HubbellJ.P. and NadasA.S. (1973): Congenital heart disease in infants of diabetic mothers - J. Pediatrics 83(5): 815–820.
SchardeinJ.L. (1980): Congenital abnormalities and hormones during pregnancy. A clinical review -Teratology 22: 251–270.
TikkanenJ.: Synnynnäisten sydänvikojen riskitekijät (Risk factors for congenital heart disease). Thesis, 1986. Health Services Research by the National Board of Health in Finland no 36, Helsinki, (In Finnish, quoted from 31).
TikkanenJ. and HeinonenO.P. (1988): Cardiovascular malformations and organic solvent exposure during pregnancy in Finland - Am. J. Ind. Med. 14: 1–8.
TikkanenJ. and HeinonenO.P. (1990): Risk factors for cardiovascular malformations in Finland - Eur. J. Epidemiol. 6(4): 348–356.
TikkanenJ. and HeinonenO.P. (1991): Maternal exposure to chemical and physical factors during pregnancy and cardiovascular malformations in the offspring - Teratology 43: 591–600.
TikkanenJ., HeinonenO.P., KurppaK. and RantalaK. (1990): Cardiovascular malformations and maternal exposure to video display terminals during pregnancy- Eur. J. Epidemiol. 6: 61–66.
TikkanenJ., KurppaK., TimonenH., HolmbergP.C., KuosmaE. and RantalaK. (1988): Cardiovascular malformations, work attendance, and occupational exposures during pregnancy in Finland - Am. J. Ind. Med. 14: 197–204.
WeberM., SchweitzerM., MurJ.M., AndreJ.M., TridonP. and VertP. (1977): Epilepsy, anticonvulsants and pregnancy - Arch. Fr. Pediatr. 34: 374–383.
WerlerM.M., MitchellA.A. and ShapiroS. (1989): The relation of aspirin use during the first trimester of pregnancy to congenital cardiac defects - N. Engl. J. Med. 321: 1639–1642.
WisemanR.A. and Dodds-SmithLC (1984): Cardiovascular birth defects and antenatal exposure to female sex hormones: a reevaluation of some base data - Teratology 30: 359–370.
YasudaM. and MillerJ.R. (1975): Prenatal exposure to oral contraceptives and transposition of the great vessels in man - Teratology 12: 239–243.
ZierlerS. and RothmanK.J. (1985): Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy - N. Engl. J. Med. 313: 347–352.
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Pradat, P. A case-control study of major congenital heart defects in Sweden — 1981–1986. Eur J Epidemiol 8, 789–796 (1992). https://doi.org/10.1007/BF00145321
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DOI: https://doi.org/10.1007/BF00145321