Risk factors for congenital heart disease among Jordanian children: A case-control study

Problem considered: Congenital heart disease (CHD) is the most common congenital birth defect worldwide. Evidence on maternal and perinatal risk factors in Jordan remains limited. This study aimed to identify factors associated with CHD among Jordanian children. Methods: An unmatched case–control study was conducted in two tertiary hospitals between January 2022 and July 2023. Children with echocardiography-confirmed CHD (n = 219) were compared with controls without CHD (n = 178). Data were collected through structured face-to-face parental interviews covering maternal, obstetric, lifestyle, and child-related factors. Logistic regression analysis was used to assess associations. Results: Family history of CHD (OR = 1.84, P = 0.028), antenatal maternal disease (OR = 1.90, P = 0.024) were significantly associated with CHD. Lower birth weight was more common among children with CHD (OR = 0.59, P = 0.01). Higher maternal education and multivitamin use were more common among controls. The most common lesions were atrial septal defect (38.8%) and ventricular septal defect (20.1%). Heart murmur was the most common presenting sign (55.3%). No significant associations were observed for some lifestyle-related exposures assessed in the study. Conclusion: This is the first echocardiography-based study to evaluate factors associated with CHD among Jordanian children, and highlighted the importance of preconception counselling, smoking cessation, and improved antenatal screening. Family history of CHD, antenatal maternal disease, and lower birth weight showed significant associations with CHD. Larger multicentre prospective studies are needed to confirm these findings and better understand potentially modifiable risk factors.