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Maternal Autoimmune Diseases and Offspring Structural Congenital Heart Disease: A Nationwide Population-Based Cohort
Li-Chin Liao1,2,3,4,5, Yi-Hsiu Fu1, Pei-Lun Liao6,7
1Department of Pediatric Cardiology, Children's Medical Center Taichung Veterans General Hospital Taichung Taiwan.
Insights
Maternal autoimmune diseases (ADs) increase the risk of congenital heart disease (CHD) in offspring. Early screening for pregnant women with ADs is crucial for detecting potential cardiac defects.
Area of Science:
- Reproductive Medicine
- Pediatrics
- Immunology
Background:
- Maternal autoimmune diseases (ADs) are linked to adverse pregnancy outcomes.
- The specific impact of maternal ADs on offspring structural congenital heart disease (CHD) requires further clarification.
Purpose of the Study:
- To evaluate the association between maternal ADs and the risk of structural CHD in offspring.
- To identify specific maternal ADs that pose a significant risk for offspring CHD.
Main Methods:
- Nationwide retrospective cohort study using Taiwan's Maternal and Child Health Database (2004-2019).
- Inclusion of 4708 live births from mothers with ADs and 9416 matched controls.
- Analysis using Cox proportional hazards models to determine adjusted hazard ratios (aHRs) for CHD.
Main Results:
- Offspring of mothers with ADs exhibited a significantly higher risk of CHD (aHR, 1.51).
- Systemic lupus erythematosus (aHR, 2.01) and Sjögren syndrome (aHR, 1.47) were significantly associated with increased offspring CHD risk.
Conclusions:
- Maternal ADs are identified as independent risk factors for offspring structural CHD.
- Highlights the need for multidisciplinary counseling and specialized fetal echocardiographic screening for pregnant women with ADs.
Background:
Maternal autoimmune diseases (ADs) are associated with adverse pregnancy outcomes, yet their specific impact on offspring structural congenital heart disease (CHD) remains inconclusive. This study aimed to evaluate the risk of structural CHD in children born to mothers with various ADs using a nationwide population-based database.
Methods:
We conducted a nationwide retrospective cohort study using the Maternal and Child Health Database in Taiwan (2004-2019), a comprehensive data set linking the National Health Insurance Research Database with birth registries. We identified 4708 live births from mothers with ADs and matched them 1:2 with 9416 control births. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for structural CHD, adjusting for maternal age, comorbidities, and pregnancy-related factors.
Results:
Offspring of mothers with ADs had a significantly higher risk of CHD compared with the control group (aHR, 1.51 [95% CI, 1.24-1.85]). Specific maternal ADs significantly associated with offspring CHD included systemic lupus erythematosus (aHR, 2.01 [95% CI, 1.55-2.60]) and Sjögren syndrome (aHR, 1.47 [95% CI, 1.10-1.96]).
Conclusions:
Maternal ADs are independent risk factors for offspring structural CHD. These findings underscore the importance of multidisciplinary counseling and specialized fetal echocardiographic screening for pregnant women with ADs to ensure early detection and management of potential cardiac defects in their offspring.
Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: CS19009.
