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Attributable fraction for cardiac malformations

P D Wilson1, C A Loffredo, A Correa-Villaseñor

  • 1Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.

American Journal of Epidemiology
|September 16, 1998
PubMed
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This study quantifies the proportion of cardiac malformations potentially preventable by addressing specific risk factors. Findings highlight key exposures like paternal marijuana use and environmental factors that could inform prenatal interventions.

Area of Science:

  • Cardiovascular Epidemiology
  • Birth Defects Research
  • Public Health

Background:

  • Cardiac malformations are a significant cause of infant mortality and morbidity.
  • Previous research identified factors associated with cardiac malformations but did not quantify their attributable fractions.
  • The Baltimore-Washington Infant Study provided a valuable dataset for investigating these associations.

Purpose of the Study:

  • To calculate attributable fractions for specific risk factors associated with major cardiac malformations.
  • To identify potentially preventable proportions of these birth defects.
  • To inform public health strategies for the prevention of congenital heart disease.

Main Methods:

  • Utilized data from the Baltimore-Washington Infant Study (1981-1989).

Related Experiment Videos

  • Calculated summary attributable fractions and extra attributable fractions for eight major cardiac malformations.
  • Analyzed the contribution of individual factors, considering both prevalence and relative risk.

    • Main Results:

    • Summary attributable fractions ranged from 13.6% (hypoplastic left heart) to 30.2% (transposition of great arteries with intact ventricular septum).
    • Largest extra attributable fractions were linked to paternal marijuana use (7.8%), painting (5.1%), and pesticide exposure (5.5%).
    • The proportion of cases exposed was a dominant factor in the attributable fraction calculations.

    Conclusions:

    • Specific environmental and lifestyle factors may be causally linked to cardiac malformations.
    • Significant proportions of certain cardiac malformations may be preventable through targeted interventions.
    • These findings underscore the potential for primary prevention strategies during the prenatal period.