Non-cardiac birth defects and long-term risk of cardiovascular hospitalisation

Area of Science:

• Reproductive Health
• Cardiovascular Epidemiology
• Congenital Anomalies

Background:

• Patients with congenital heart defects are recognized to have an elevated risk of developing cardiovascular disease.
• The association between non-cardiac birth defects and subsequent cardiovascular disease risk remains less understood.

Purpose of the Study:

• To investigate the association between non-cardiac birth defects and the risk of cardiovascular hospitalisation in a large cohort of parous women.
• To quantify the risk of cardiovascular hospitalisation associated with specific types of non-cardiac birth defects.

Main Methods:

• A longitudinal cohort study was conducted involving 1,451,409 parous women in Quebec, Canada, from 1989 to 2022.
• Women with cardiac and non-cardiac birth defects (urinary, central nervous, digestive systems) were compared to women without defects.
• Cox proportional hazards regression models were used to assess the association between birth defects and cardiovascular hospitalisation (coronary artery disease, ischaemic stroke) over 33 years of follow-up.

Main Results:

• Women with any birth defect exhibited a higher cardiovascular hospitalisation rate (7.0 per 1000 person-years) compared to those without (3.3 per 1000 person-years).
• Non-cardiac defects were associated with a 1.61-fold increased risk of cardiovascular hospitalisation.
• Isolated urinary defects (HR 3.93), central nervous system defects (HR 3.33), and digestive defects (HR 2.39) conferred the greatest risks. Heart defects showed the highest risk (HR 10.30).

Conclusions:

• Both cardiac and non-cardiac birth defects are significantly associated with an increased risk of developing cardiovascular disease in parous women.
• Specific non-cardiac anomalies, particularly those affecting the urinary and central nervous systems, substantially elevate cardiovascular hospitalisation risk.