Birth weight and cardiovascular malformations: a population-based study. The Baltimore-Washington Infant Study

Area of Science:

• Pediatric Cardiology
• Congenital Cardiovascular Malformations
• Neonatal Health

Background:

• Congenital cardiovascular malformations (CCMs) are a significant concern in pediatric health.
• Previous studies have suggested an association between CCMs and altered birth weight, but causal relationships remain debated.
• Understanding factors influencing birth weight in infants with CCMs is crucial for clinical management and research.

Purpose of the Study:

• To investigate the relationship between specific congenital cardiovascular malformations and mean birth weights in a population-based cohort.
• To determine if infants with CCMs are more likely to have low birth weight for gestational age after adjusting for confounding factors.

Main Methods:

• A population-based case-control study was conducted involving liveborn singletons without extracardiac anomalies.
• Infants diagnosed with D-transposition of the great arteries, tetralogy of Fallot, endocardial cushion defect, hypoplastic left heart syndrome, pulmonary stenosis, aortic stenosis, coarctation of the aorta, ventricular septal defect, and atrial septal defect were included.
• Statistical adjustments were made for maternal, gestational, and infant factors to assess birth weight and low birth weight for gestational age.

Main Results:

• Significant birth weight deficits were observed in infants with tetralogy of Fallot, endocardial cushion defect, hypoplastic left heart syndrome, pulmonary stenosis, coarctation of the aorta, ventricular septal defect, and atrial septal defect after adjustments.
• Infants with most of these malformations (excluding coarctation of the aorta and atrial septal defect) were significantly more likely to be classified as having low birth weight for gestational age compared to controls.

Conclusions:

• The findings provide stronger evidence for a potential causal relationship between specific congenital cardiovascular malformations and low birth weight.
• Certain CCMs are associated with both reduced mean birth weight and an increased likelihood of low birth weight for gestational age.
• These results highlight the importance of considering birth weight in the context of congenital heart defects and may inform future research into underlying mechanisms.