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Risk factors in the origin of congenital left-ventricular outflow-tract obstruction defects of the heart: a

Melinda Csáky-Szunyogh1, Attila Vereczkey, Zsolt Kósa

  • 1Hungarian Congenital Abnormality Registry, National Institute for Health Development, Nagyvárad tér 2, Budapest, 1096, Hungary.

Pediatric Cardiology
|July 12, 2013
PubMed

Insights

Maternal diabetes and panic disorder are linked to congenital heart defects (CHDs), specifically left-ventricular outflow tract (LVOT) obstructive defects. High folic acid intake may protect against these defects, particularly coarctation of the aorta (COA).

Area of Science:

  • Cardiology
  • Developmental Biology
  • Public Health

Background:

  • Congenital heart defects (CHDs), particularly left-ventricular outflow tract (LVOT) obstructive defects, often have unclear etiological factors.
  • Understanding these causes is crucial for prevention and management strategies.
  • Existing research highlights the complexity and multifactorial nature of CHD origins.

Purpose of the Study:

  • To investigate potential etiological factors contributing to the development of various left-ventricular outflow tract (LVOT) obstructive defects.
  • To analyze the association between maternal health conditions, medications, and supplement use with specific CHDs.
  • To identify risk and protective factors for LVOT defects using a large population-based dataset.

Main Methods:

  • Utilized the Hungarian Case Control Surveillance of Congenital Abnormalities dataset.
  • Compared 302 live-born cases with LVOT defects (including valvular aortic stenosis, hypoplastic left heart syndrome, coarctation of the aorta) against multiple control groups (matched, unaffected, and other malformed controls).
  • Evaluated pregnancy complications, chronic/acute diseases, drug treatments (e.g., ampicillin), and folic acid/multivitamin supplementation using maternal logbooks and medical records.

Main Results:

  • Maternal diabetes was identified as a risk factor for LVOT defects generally.
  • Panic disorder was associated with an increased risk of hypoplastic left heart syndrome.
  • Ampicillin treatment during pregnancy correlated with a higher risk of coarctation of the aorta (COA), while high-dose folic acid showed a protective effect, especially for COA.

Conclusions:

  • Identified specific maternal factors (diabetes, panic disorder, ampicillin use) associated with LVOT defects.
  • Highlighted the protective role of high-dose folic acid against certain LVOT defects like COA.
  • Emphasized the need for further research to elucidate the remaining unknown causes of congenital heart defects.

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