[Risk factors for the development of congenital heart defects in children born in the Tuzla Canton]

Congenital heart diseases (CHD) are taking high position on the list of neonatal and infant mortality, and they are significantly involved in mortality of children and adults. During cardiogenesis various genetic and non-genetic ethiological factors are starting pathogenetic mechanism what results in developing of CHD. Purpose of research is evaluation of participation of some risk-factors in developing of CHD in children on Tuzla Canton area. This research included 352 children up to 15 years old, in which was discovered CHD during period from 1.1.1994 to 31.12.1999. Using method of anamnestic questionnaire we analyzed data related to occurence of CHD in relatives, reproductive age of mother, mother's illness and taking medications in first trimester of pregnancy, and professional exposure to harmful chemicals. In 24 or 6.81% of cases CHD was registered in one of first-degree relatives, and in only one case in second-degree of relatives. It was noticeable that CHD in highest number of cases (291 or 83.14%) were present in children whose mothers were 20-35 years old, while only 18 or 5.11% of mothers aged 35 and more what is considered as high risk age for development of anomalies in general. In 70 or 20% cases CHD was associated with other systems anomalies, including syndromes and chromosomopathies. Risk-factors related to earlier pregnancies of mothers were found in 40 (11.36%) of children. Data about acute and chronic diseases of mother during pregnancy were found in 36 children. analysis of exposure to harmful chemicals during first trimester of pregnancy is showing that 39 or 11.08% mothers were exposed to nicotine, while 17 or 4.83% were taking medications. Exposure to professional poisoning were found in 5 or 1.42% of cases. Results of research are pointing on need for continued observation genetic and wide range of other potential risk-factors from environment related to development of CHD in our area. This way we could explain some specific characteristic occurrences of CHD in some areas.