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| Analysis of the risk factors of women with different types of fetal congenital heart disease before pregnancy or during the first trimester of pregnancy |
| 1.Henan Institute of Reproduction Health Science and Technology, National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, 450052; 2. The First Affiliated Hospital of Zhengzhou University; 3. Maternal and Child Health Care Hospital of Henan Province |
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Abstract To analyze the risk factors of women with different types of fetal congenital heart disease (CHD) before pregnancy or during the first trimester of pregnancy, so as to provide scientific basis for the intervention of birth defects of the fetal CHD. Methods: 319 pregnant women with prenatal diagnosis of fetal CHD were selected in case group, and the women with normal pregnancy after examination were selected in control group based on 1:1 ratio from January 2019 to June 2019. A questionnaire was used to collect the basic family information and the information on maternal exposure factors of the women in the two groups before pregnancy or during the first trimester of pregnancy. The influencing factors of different types of fetal CHD were analyzed. Results: The most common type of simple fetal CHD was ventricular septal defect (VSD), accounting for 50.7%. The pregnant number ≥3times (OR=1.567, 95%CI 1.288-3.927) and the malnutrition during pregnancy (OR=2.378，95%CI 1.182-5.721) of the women were the risk factors of their offspring with simple CHD. Among 108 women with complex fetal CHD, the tetralogy of Fallot was the main type, accounting for 38.9%. The maternal age (OR=1.938，95%CI 1.077-3.627), the occupational exposure (OR=5.199, 95%CI 2.730-11.024), the perinatal smoking and drinking (OR=3.539, 95%CI1.736-6.892), the TORCH pathogens infections (OR=2.178, 95%CI 1.109-4.685), and the exposure to animals (OR=2.611, 95%CI 1.278-5.821) of the women were the risk factors for the development of the complex CHD of their offspring. The perinatal folic acid supplementation (OR=0.483, 95%CI 0.307-0.935) of the women was a protective factor for their fetal complex CHD. The adverse pregnancy history (OR=4.436, 95%CI 1.192-12.027, and OR=6.478, 95%CI 1.782-15.789), the colds during the first trimester of pregnancy (OR=4.878, 95%CI 1.153-14.792, and OR=4.101, 95%CI 1.063-12.381), the drugs used during the first trimester of pregnancy (OR=2.281, 95%CI 1.0075.022, and OR=1.732, 95%CI 1.006-2.832), the negative life events (OR=2.578, 95%CI 1.483-4.872, and OR=3.087, 95%CI 1.735-6.342), and the poor maternal living environment (OR=1.729, 95%CI 1.049-2.998, and OR=2.421, 95%CI 1.157-5.233) of the women were the risk factors of their fetal complex or simple CHD. Conclusion: The health guidance and education of the pregnant women with fetal CHD are conducted based on their risk factors. The primary prevention of birth defects is important for reducing the incidence of their fetal CHD, especially of their complex fetal CHD.
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