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Infants with single ventricle: a population-based epidemiological study
Eileen K Steinberger1, Charlotte Ferencz, Christopher A Loffredo
1Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Insights
Paternal alcohol and smoking are linked to single ventricle heart defects in infants. These environmental factors may play a role in the development of this rare congenital condition.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Defects
- Epidemiology
Background:
- Single ventricle is a rare congenital cardiac defect.
- It often occurs within complex cardiovascular abnormalities.
- Epidemiologic associations are not well understood.
Purpose of the Study:
- To investigate epidemiologic associations of single ventricle.
- To evaluate infant, family, and parental exposure factors.
- To analyze associations based on cardio-visceral situs.
Main Methods:
- Population-based case-control study using Baltimore-Washington Infant Study (BWIS) data (1981-89).
- Evaluated 55 infants with single ventricle against 3,572 controls.
- Used odds ratios and 95% confidence intervals to measure associations.
Main Results:
- Paternal alcohol consumption (OR=2.0) and smoking (OR=2.4) associated with all single ventricle cases.
- Associations were stronger in infants with abnormal situs.
- Maternal abortion history (OR=3.2) and paternal marijuana use (OR=2.2) also showed associations.
Conclusions:
- Paternal smoking and alcohol consumption identified as potential risk factors.
- Highlights the need to consider environmental factors in single ventricle pathogenesis.
- Further research is warranted.
Background:
Single ventricle, a rare congenital cardiac defect, often occurs as part of a complex group of cardiovascular abnormalities. Little is known of its epidemiologic associations.
Methods:
Using data from the Baltimore-Washington Infant Study [BWIS], (1981-89), a population based case-control study of cardiovascular malformations, infants with single ventricle were evaluated with respect to infant and family characteristics and maternal and paternal exposures. The cases were analyzed according to presence/absence of abnormal cardio-visceral situs. Controls were 3,572 infants without heart defects randomly selected from the regional cohort of live births. Odds ratios and 95% confidence intervals were used as measures of association.
Results:
Single ventricle occurred in 1.25% of infants with congenital cardiovascular defects in the BWIS. Fifty-five infants had single ventricle. In 48 families (87.3%) the parents were interviewed. Thirty-three infants had normal situs and 15 had abnormal situs. Paternal alcohol consumption (OR = 2.0, 95% CI 1.1-3.9) and paternal cigarette smoking (OR = 2.4, 95% CI 1.1-5.1) were associated with all cases of single ventricle. These associations were even stronger in the subset of infants with abnormal situs. Maternal history of a previous induced abortion was also associated with infants born with abnormal situs (OR = 3.2, 95% CI 1.1-11.5). Paternal marijuana use was associated with cases of single ventricle in normal situs (OR = 2.2, 95% CI 1.0-5.2).
Conclusions:
Potential risk factors included paternal smoking and alcohol consumption, highlighting the need for future studies to consider environmental factors in the pathogenesis of this cardiac defect.
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