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Epidemiology of nonsyndromic conotruncal heart defects in Texas, 1999-2004
Jin Long1, Tunu Ramadhani, Laura E Mitchell
1Institute of Biosciences and Technology, Texas A&M University System Health Science Center, Houston, TX 77382, USA.
Insights
This study investigated risk factors for three conotruncal heart defects (CTDs). Advancing maternal age increased risk for all three, with other factors varying by specific CTD.
Area of Science:
- Epidemiology
- Pediatric Cardiology
- Birth Defects Research
Background:
- Congenital heart defects (CHDs) are common but poorly understood.
- Conotruncal heart defects (CTDs) are a subgroup of CHDs.
- Etiologic heterogeneity may exist even within CTD subgroups.
Purpose of the Study:
- To identify and compare maternal and infant characteristics associated with three specific CTDs: truncus arteriosus (TA), dextro-transposition of the great arteries (d-TGA), and tetralogy of Fallot (TOF).
Main Methods:
- Utilized data from the Texas Birth Defects Registry (1999-2004) for nonsyndromic cases.
- Employed Poisson regression to estimate prevalence ratios for each condition.
- Used polytomous logistic regression to compare associations between d-TGA and TOF.
Main Results:
- Prevalence rates per 10,000 live births: TA (0.35), d-TGA (1.98), TOF (2.40).
- Advancing maternal age significantly increased risk for all three CTDs.
- Specific associations found: TA with Texas-Mexico border residence; d-TGA with infant sex, maternal race/ethnicity, prior birth history, birth year; TOF with maternal race/ethnicity and education.
- Significant differences in variable associations were noted between d-TGA and TOF.
Conclusions:
- Findings contribute to the limited understanding of CTD epidemiology.
- Highlights distinct risk factor profiles for different CTDs.
Introduction:
Congenital heart defects (CHDs) are the most common structural birth defects, yet their etiology is poorly understood. As there is heterogeneity within the group of CHDs, epidemiologic studies often focus on subgroups, of conditions, such as conotruncal heart defects (CTDs). However, even within these subgroups there may be etiologic heterogeneity. The aim of the present study was to identify and compare maternal and infant characteristics associated with three CTDs: truncus arteriosus (TA), dextro-transposition of the great arteries (d-TGA), and tetralogy of Fallot (TOF).
Methods:
Data for cases with nonsyndromic TA (n = 78), d-TGA (n = 438), and TOF (n = 529) from the Texas Birth Defects Registry, 1999-2004, were used to estimate crude and adjusted prevalence ratios, separately for each condition, using Poisson regression. Polytomous logistic regression was used to determine whether the observed associations were similar across the two largest case groups (d-TGA and TOF).
Results:
In Texas, 1999-2004, the prevalence of nonsyndromic TA, d-TGA, and TOF was 0.35, 1.98, and 2.40 per 10,000 live births, respectively. There was evidence of a significant linear increase in the risk of each condition with advancing maternal age (p < 0.01). Significant associations were observed for TA and maternal residence on the Texas-Mexico border; d-TGA and infant sex, maternal race/ethnicity, history of previous live birth, and birth year; and TOF and maternal race/ethnicity and education. Further, the associations with some, but not all, of the study variables were significantly different for d-TGA and TOF.
Conclusion:
These findings add to our limited understanding of the epidemiology of CTDs.
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