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Congenital heart defects--chromosomal anomalies, syndromes and extracardiac malformations
Alf Meberg1, Jardar Hals, Erik Thaulow
1Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway. alfmeb@start.no
Insights
Nearly a quarter of congenital heart defect (CHD) cases involve chromosomal anomalies or other malformations. Muscular ventricular septal defects (VSDs) showed fewer associated conditions. Increased trisomy prevalence in CHDs may link to maternal age. Keywords: congenital heart defects, chromosomal anomalies, malformations, ventricular septal defects, maternal age.
Area of Science:
- Cardiology
- Genetics
- Pediatrics
Background:
- Congenital heart defects (CHDs) are common birth anomalies.
- Associated chromosomal anomalies, genetic syndromes, and extracardiac malformations can impact CHD outcomes.
- Understanding the prevalence and types of these associated conditions is crucial for diagnosis and management.
Purpose of the Study:
- To document the occurrence of chromosomal anomalies, syndromes, and extracardiac malformations in patients diagnosed with congenital heart defects (CHDs).
- To investigate the relationship between the location of ventricular septal defects (VSDs) and associated anomalies.
- To analyze trends in the prevalence of CHDs with associated disorders over time and explore potential contributing factors.
Main Methods:
- A population-based prospective observational study was conducted.
- Data were collected on live births between 1982 and 2005.
- Statistical analyses were performed to compare prevalence rates and identify significant associations.
Main Results:
- Out of 57,027 live births, 662 (11.6 per 1000) had CHDs, with 146 (22%) exhibiting associated anomalies.
- Chromosomal anomalies (excluding microdeletions) were present in 52 cases (36%), genetic syndromes/microdeletions in 26 (18%), and extracardiac malformations in 67 (46%).
- Perimembranous VSDs had a significantly higher rate of associated anomalies (31%) compared to muscular VSDs (9%). The prevalence of CHDs with chromosomal trisomies increased from 1982-1993 to 1994-2005, correlating with an increase in maternal age at childbirth.
Conclusions:
- Chromosomal anomalies, syndromes, and extracardiac malformations are found in approximately 22% of congenital heart defect cases.
- Congenital heart defects associated with muscular VSDs demonstrate a lower incidence of these additional conditions.
- The rising prevalence of CHDs with chromosomal trisomies is likely associated with the increasing average age of mothers giving birth.
Aim:
To register chromosomal anomalies, syndromes and extracardiac malformations in patients with Congenital heart defects (CHDs).
Method:
Population-based prospective observational study.
Results:
Of 57 027 live births during 1982-2005, CHDs were detected in 662 (11.6 per 1000), of whom 146 (22%) had associated anomalies. Of these 52 (36%) had chromosomal anomalies (exclusive microdeletions), 26 (18%) genetic syndromes/microdeletions, 1 (0.7%) a teratogenous syndrome and 67 (46%) extracardiac malformations. In perimembraneous ventricular septal defects (VSDs), associated anomalies occurred in 22 of 70 (31%) compared to 27 of 298 (9%) in VSDs located in the muscular part of the septum (p < 0.0001). The prevalence of CHDs with associated disorders increased significantly from the cohort born during 1982-1993 to those born during 1994-2005 (2.0 vs. 3.1 per 1000, respectively; p < 0.0001), mainly caused by an increase of chromosomal trisomies (0.5 vs. 1.1 per 1000; p = 0.026). The percentage of women giving live birth at 35 years of age or more was 7.6% for the period 1982-1993 compared to 13.4% for 1994-2005 (p = 0.001).
Conclusions:
Chromosomal anomalies, syndromes and extracardiac malformations occurred in nearly one-fourth of CHD cases. Muscular VSDs had a low prevalence of such conditions. The prevalence of CHDs with chromosomal trisomies increased, and was probably related to an increasing age of women giving birth.
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