Related Experiment Videos
Seasonality in live births with congenital heart disease in Malta
1Paediatric Department, St Luke's Hospital, Guardamangia, Malta. victor.e.grech@magnet.mt
Insights
Congenital heart disease requiring intervention showed a seasonal peak in September in Malta. Lesions not needing intervention did not exhibit seasonal trends, suggesting specific environmental factors may influence severe congenital heart disease.
Area of Science:
- Cardiology
- Pediatrics
- Public Health
Background:
- Congenital heart disease (CHD) is a significant global health concern.
- Understanding etiological factors, including environmental influences, is crucial for prevention.
- Seasonal variations in birth defects have been observed, but findings are inconsistent.
Purpose of the Study:
- To investigate seasonal variations in live births with congenital heart disease (CHD) in Malta.
- To differentiate seasonal trends between CHD requiring intervention and those not requiring intervention.
Main Methods:
- Retrospective analysis of 231 live births diagnosed with CHD between 1990 and 1994 in Malta.
- Diagnosis confirmed by echocardiography, cardiac catheterization, surgery, or post-mortem.
- Statistical analysis using Chi-squared (X2) tests and Edwards' cyclic method.
Main Results:
- Overall CHD prevalence showed no significant seasonal variation.
- CHD requiring intervention demonstrated a significant seasonal peak in September (p = 0.03), enhanced by seasonal analysis (p = 0.003).
- Mild pulmonary stenosis and small ventricular septal defects (96% of non-intervention cases) showed no seasonal trend.
Conclusions:
- Specific types of congenital heart disease requiring intervention may be influenced by seasonal environmental factors.
- Maternal viral infections or treatments during early pregnancy (November-January) could be potential triggers for severe CHD in predisposed fetuses.
- Further research into environmental factors and their impact on specific CHD subtypes is warranted.
Abstract:
This study was carried out to analyse seasonal variations in live births with congenital heart disease in the overall population of Malta. Included were all patients diagnosed as having congenital heart disease by echocardiography, cardiac catheterization, surgery or post mortem, by 1 year of age, and who were born between in Malta between 1990 and 1994. Results were analysed by X2 and by Edwards' cyclic method. There were 231 cases of live born congenital heart disease, which were divided into 114 cases not requiring intervention and 117 cases requiring intervention. Although the overall prevalence of congenital heart disease did not demonstrate any seasonal variation, the lesions requiring intervention showed a significant peak in September by Edwards' method (p = 0.03), which was enhanced by seasonal analysis (p = 0.003). These results were confirmed by conventional X2 and X2 for trend. The lesions not requiring intervention, which were comprised almost entirely (96%) of mild pulmonary stenosis and small ventricular septal defects, failed to show any seasonal trend. The literature regarding such seasonal trends in these malformations and statistical analysis of seasonality of congenital heart disease are reviewed. An environmental factor such as a maternal viral infection or treatment of such infections during the first trimester of pregnancy from November to January may precipitate congenital heart disease in predisposed Maltese foetuses.