The Impact of Maternal Risk Factors and Drinking Water Contaminants on Birth Defects

The leading cause of infant deaths in the United States is birth defects, accounting for 20% of infant deaths. Cyanotic Congenital Heart Defects (CCHD) is a major birth defect with a mortality rate of 25%. In addition, the rate of CCHD increased 18% from 2016 to 2022 nationwide. However, few studies have identified risk factors for this increasing trend. This study assessed the influence of maternal risk factors and drinking water contaminants on CCHD and proposed a solution to reduce CCHD rate. Crude odds ratios (ORs) from binary logistic regression analysis show significant association between CCHD and maternal age ≥35 (OR:1.18, 95% Confidence Intervals (CI): 1.03-1.30), pre-pregnancy diabetes (OR:4.19, 95% CI: 3.47-5.06), and gestational diabetes (OR:1.23, 95% CI: 1.08-1.31). In addition, these ORs have decreasing trends from 2016 to 2022, suggesting the influence of these risk factors on CCHD is decreasing. Utah has the highest CCHD rate among 50 states, accounting for 10.4% of CCHD cases. Both drinking water nitrate concentration and CCHD rate show similar increasing trends in Utah. Logistic regression analysis of nitrate concentration in drinking water and CCHD indicates a significant and positive correlation between CCHD and nitrate concentration in drinking water. These findings suggest the CCHD increasing trend may be associated with the identified maternal risk factors. Furthermore, high CCHD rates in Utah may be correlated with nitrate concentration in drinking water. Thus, reducing these risk factors may decrease CCHD rate.