Maternal Risk Factors and Pattern of Congenital Heart Disease in Neonate in a Tertiary Level Hospital

Background: Congenital heart disease (CHD) is one of the most common congenital anomalies and an important cause of neonatal morbidity and mortality. Early detection is essential for timely intervention, improved prognosis, and appropriate parental counseling. Objective: This study aimed to determine the pattern of CHD among neonates and identify associated maternal risk factors. Methods: A hospital-based descriptive cross-sectional study was conducted in the Department of Neonatology, Mymensingh Medical College Hospital, Bangladesh, from November 2016 to April 2017. Neonates with suspected CHD fulfilling the inclusion criteria were enrolled. Detailed maternal and neonatal histories and clinical examinations were performed. Chest X-ray, electrocardiography, and echocardiography were conducted to confirm cardiac defects. Relevant findings were recorded using a predesigned questionnaire. Results: Of 3,028 admitted neonates, 44 (1.5%) had definite CHD. Among them, 77.3% were term, 22.7% preterm, and 61.4% had birth weight <2.5 kg; the male-to-female ratio was 1.1:1. Consanguinity was present in 22.7% of cases, irregular antenatal care in 61.4%, and maternal drug exposure in 25.0%. Maternal gestational diabetes, hypertension, urinary tract infection, and flu-like fever were reported in 11.4%, 4.5%, 11.4%, and 9.1% of cases, respectively. Acyanotic CHD accounted for 89%, while cyanotic CHD accounted for 11.0%. Patent ductus arteriosus (PDA) was the most common defect (22.7%), followed by ventricular septal defect (VSD) (20.5%) and atrial septal defect (ASD) (13.6%). Respiratory distress was the commonest symptom (70.4%). Down syndrome was present in 6.8% of neonates. Overall, 84.1% improved and were discharged, while 15.9% died. Conclusion: CHD was detected in 1.5% of hospitalized neonates, with acyanotic defects predominating. PDA was the most frequent lesion. Maternal diabetes, hypertension, infections, consanguinity, and drug exposure were commonly observed risk factors. Early diagnosis and appropriate parental counseling may facilitate timely intervention and reduce neonatal morbidity and mortality.