Birth outcomes of cases with left-sided obstructive defects of the heartin the function of maternal socio-demographic factors: a population-based case-control study

Abstract

Objective: To evaluate the birth outcomes and maternal variables of cases with different types of left-sided obstructive defects (LSOD) of the heart. Methods: Live-born infants were selected from the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, and 302 cases with LSOD, 469 matched controls and 38,151 all controls without any defect, and 20,750 malformed controls with other isolated defects were compared. The diagnosis of LSOD was based on autopsy report or the documents of surgical intervention. Results: Four types of LSOD were differentiated: 56 cases with valvular aortic stenosis (VAS), 76 cases with hypoplastic left heart syndrome (HLHS), 113 cases with coarctation of the aorta (COA) and 57 cases with other congenital abnormalities of aorta (OCA). Cases with LSOD had male excess (64.6%) with a higher rate of preterm birth (14.2 vs. 6.6%) and low birthweight (15.6 vs. 4.3%) compared to matched controls. The high rate of preterm birth was particularly characteristic for HLHS (17.1%) while intrauterine fetal growth restriction was found in cases OCA (22.8%) and COA (13.3%). The mothers of cases with LSOD had higher birth order and lower socio-economic status than controls without any defect. Conclusions: The general pattern of birth outcomes and maternal variables were similar in the types of LSOD cases, but the higher rate of preterm birth and low birthweight indicated some association with their adverse fetal development.

Keywords::

• Coarctation of aorta
• hypoplastic left heart syndrome
• left-sided obstructive defect
• low birthweight
• maternal age
• population-based case-control study
• preterm birth
• valvular aortic stenosis

Declaration of Interest: This project was supported by the Hungarian Egészségügyi Tudományos Tanács Pályázati Irodája (Grant Office of Scientific Committee of Health Ministry) and Versys Clinics, Human Reproduction Institute, Budapest, Hungary. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.