Version August 2024
| Estimated RR or OR* | Associated CHD lesions | |
| Preterm birth (GA <37 weeks)[1] | OR 2.4 (95% CI 2.2-2.7) | Various |
| Multifetal pregnancy[2] | OR 4.53 (95% CI 4.28-4.8) | RVOTO lesions, VSD, ASD |
| In utero infection | ||
| Rubella[3] | Cardiac defects occur in 10 to 20% of infants with congenital rubella | PDA and peripheral pulmonary artery stenosis |
| Maternal influenza or flu-like illness[4] | OR 2.04 (95% CI 1.27-3.27) | RVOTO lesions |
| Maternal factors | ||
| Preeclampsia[5] | RR 1.57 (95% CI 1.48-1.67) | Septal defects |
| Type 1 DM[6] | OR 3.77 (95% CI 3.26-4.36) | Heterotaxy syndrome, conotruncal defects, AVSD, LVOTO and RVOTO lesions |
| Gestational DM[6] | OR 1.07 (95% CI 1.01-1.14) | Same as for type 1 DM |
| Hypertension[2] | OR 1.81 (95% CI 1.61-2.03) | RVOTO, VSD, ASD |
| Obesity[2] | OR 1.48 (95% CI 1.32-1.65) | Various |
| Thyroid disorders[2] | OR 1.45 (95% CI 1.26-1.67) | Various |
| Systemic connective tissue disorders[2] | OR 3.01 (95% CI 2.23-4.06) | Heterotaxy syndrome |
| Epilepsy and mood disorders¶[2] | OR 1.41 (95% CI 1.16-1.72) | Various |
| Age ≥40 years[2] | OR 1.48 (95% CI 1.39-1.58) | AVSD |
| Alcohol or substance use[2] | OR 1.88 (95% CI 1.74-2.04) | RVOTO, VSD, ASD |
| First-trimester cigarette smoking[7] | OR 1.9 (95% CI 1.04-3.45) OR 1.32 (95% CI 1.06-1.65) OR 1.36 (95% CI 1.04-1.78) | Truncus arteriosus RVOTO Secundum ASD |
| Maternal medications during pregnancy: Increased risk of CHD has been reported with thalidomide, ACE inhibitor, retinoic acid, NSAIDs, phenytoin, and lithium | Estimates vary | Various NSAIDs are associated with D-TGA, AVSD, VSD, bicuspid aortic valve Lithium has been reported to be associated with Ebstein anomalyΔ |
| Assisted reproductive technology[8] | RR 1.64 (95% CI 1.30-2.07) | Various |
| Family history of CHD[9] | ||
| First-degree relative with any CHD | RR 3.21 (95% CI 2.96-3.49) | Various |
| Second-degree relative with any CHD | RR 1.78 (95% CI 1.09-2.91) | Various |
| First-degree relative with heterotaxy | RR 79.1 (95% CI 32.9-190.0) | Heterotaxy |
| First-degree relative with RVOTO | RR 48.6 (95% CI 27.5-85.6) | RVOTO |
| First-degree relative with AVSD | RR 24.3 (95% CI 12.2-48.7) | AVSD |
| First-degree relative with LVOTO | RR 12.9 (95% CI 7.48-22.20) | LVOTO |
| First-degree relative with conotruncal defect | RR 11.7 (95% CI 8.01-17.00) | Conotruncal defect |
| First-degree relative with isolated ASD | RR 7.07 (95% CI 4.51-11.10) | ASD |
| First-degree relative with isolated VSD | RR 3.41 (95% CI 2.20-5.29) | VSD |
ACE: angiotensin-converting enzyme; ASD: atrial septal defect; AVSD: atrioventricular septal defect; CHD: congenital heart disease; DM: diabetes mellitus; D-TGA: D-transposition of the great arteries; GA: gestational age; LVOTO: left ventricular outflow tract obstruction; NSAID: nonsteroidal anti-inflammatory drug; OR: odds ratio; PDA: patent ductus arteriosus; RR: relative risk; RVOTO: right ventricular outflow tract obstruction; VSD: ventricular septal defect.
* These estimates are relative effect estimates. The absolute risk depends on the baseline prevalence of the CHD defect. The overall prevalence of CHD in the general population is approximately 1%.
¶ The association of CHD with mood disorders is most likely reflective of the medications used in the treatment of these disorders.
Δ The association of lithium with Ebstein anomaly is controversial; however, screening for CHD is generally recommended for infants exposed to lithium during the first or second trimester of pregnancy. Refer to the UpToDate topics on teratogenic and postnatal risks of lithium and prenatal screening for fetal cardiac abnormalities for more details.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
