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Non-cardiac birth defects and long-term risk of cardiovascular hospitalisation
Nathalie Auger1,2,3,4, Gilles Paradis2,3, Jessica Healy-Profitós5,3
1University of Montreal Hospital Centre Research Centre, Montreal, Québec, Canada nathalie.auger@inspq.qc.ca.
Insights
Women with birth defects, including non-cardiac ones, face a higher risk of cardiovascular hospitalisation. This study highlights the link between birth anomalies and future heart health in parous women.
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.
Background:
Patients with heart defects are at risk of developing cardiovascular disease. Our objective was to determine if non-cardiac birth defects are associated with the risk of cardiovascular hospitalisation.
Methods:
We conducted a longitudinal cohort study of 1 451 409 parous women in Quebec, Canada. We compared patients with cardiac and non-cardiac birth defects of the urinary, central nervous and other systems against patients without defects between 1989 and 2022. The main outcome was hospitalisation for coronary artery disease, ischaemic stroke and other cardiovascular outcomes during 33 years of follow-up. We computed cardiovascular hospitalisation rates and used Cox proportional hazards regression models to measure the association (HR; 95% CI) between non-cardiac defects and later risk of cardiovascular hospitalisation, adjusted for patient characteristics.
Results:
Women with any birth defect had a higher rate of cardiovascular hospitalisation than women without defects (7.0 vs 3.3 per 1000 person-years). Non-cardiac defects overall were associated with 1.61 times the risk of cardiovascular hospitalisation over time, compared with no defect (95% CI 1.56 to 1.66). Isolated urinary (HR 3.93, 95% CI 3.65 to 4.23), central nervous system (HR 3.33, 95% CI 2.94 to 3.76) and digestive defects (HR 2.39, 95% CI 2.16 to 2.65) were associated with the greatest risk of cardiovascular hospitalisation. These anomalies were associated with cardiovascular hospitalisation whether they presented alone or clustered with other defects. Nevertheless, heart defects were associated with the greatest risk of cardiovascular hospitalisation (HR 10.30, 95% CI 9.86 to 10.75).
Conclusion:
The findings suggest that both cardiac and non-cardiac birth defects are associated with an increased risk of developing cardiovascular disease among parous women.
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