Maternal pre-pregnancy diabetes (OR 2.91), passive smoking (OR 2.67), chronic hypertension (OR 1.39), active smoking (OR 1.28), and obesity (OR 1.23) significantly increased the risk of overall CHD.
Meta-Analysis (n=29,887,029)
Do maternal risk factors during the first trimester increase the risk of congenital heart defects in offspring?
Maternal factors such as pre-pregnancy diabetes, obesity, smoking, and chronic hypertension during the first trimester significantly increase the risk of congenital heart defects in offspring.
Effect estimate: OR 2.91 (95% CI 2.10-4.03)
Congenital heart defect (CHD) is a leading cause of neonatal mortality, with early maternal risk factors playing a significant role in its development. This systematic review and meta-analysis investigated the relationship between maternal factors during the first trimester and CHD. The study protocol was registered on PROSPERO (CRD42023476855). MEDLINE, Embase, and Cochrane TRIALS were systematically searched for eligible cohort and case-control studies. The primary outcome was the risk of the fetus developing CHD under the effects of maternal factors. The outcome was estimated by odds ratios (ORs) and 95% confidence interval (CI) using the random-effects model. Seventy-eight studies with 393 534 cases and 29 493 495 controls were included. Maternal pre-pregnancy diabetes (OR 2.91, 95% CI 2.10-4.03), obesity (OR 1.23, 95% CI 1.13-1.33), active (OR 1.28, 95% CI 1.03-1.57) and passive smoking (OR 2.67, 95% CI 1.30-5.46), and chronic hypertension (OR1.39, 95% CI 1.02-1.90) significantly increased the risk of overall CHD in offspring. While underweight was not associated with overall CHD, it showed a slight association with ventricular septal defect (OR 1.10, 95% CI 1.02-1.18). These findings emphasize the importance of optimizing maternal health and lifestyle before and during pregnancy and provide evidence for public health strategies to reduce the risk of CHD.
Suo et al. (Mon,) conducted a meta-analysis in Congenital heart defect (n=29,887,029). Maternal factors during the first trimester vs. Absence of maternal risk factors was evaluated on Risk of the fetus developing CHD (OR 2.91, 95% CI 2.10-4.03). Maternal pre-pregnancy diabetes (OR 2.91), passive smoking (OR 2.67), chronic hypertension (OR 1.39), active smoking (OR 1.28), and obesity (OR 1.23) significantly increased the risk of overall CHD.