• Hsin-Hsu Chou, Meng-Jiun Chiou, Fu-Wen Liang, Lea-Hua Chen, Tsung-Hsueh Lu, and Chung-Yi Li.
• Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan.
• CMAJ. 2016 Dec 6; 188 (17-18): E438-E446.

BackgroundInformation about known risk factors for congenital heart disease is scarce. In this population-based study, we aimed to investigate the relation between maternal chronic disease and congenital heart disease in offspring.MethodsThe study cohort consisted of 1 387 650 live births from 2004 to 2010. We identified chronic disease in mothers and mild and severe forms of congenital heart disease in their offspring from Taiwan's National Health Insurance medical claims. We used multivariable logistic regression analysis to assess the associations of all cases and specific types of congenital heart disease with various maternal chronic diseases.ResultsFor mothers with the following chronic diseases, the overall prevalence of congenital heart disease in their children was significantly higher than for mothers without these diseases: diabetes mellitus type 1 (adjusted odds ratio [OR] 2.32, 95% confidence interval [CI] 1.66-3.25), diabetes mellitus type 2 (adjusted OR 2.85, 95% CI 2.60-3.12), hypertension (adjusted OR 1.87, 95% CI 1.69-2.07), congenital heart defects (adjusted OR 3.05, 95% CI 2.45-3.80), anemia (adjusted OR 1.31, 95% CI 1.25-1.38), connective tissue disorders (adjusted OR 1.39, 95% CI 1.19-1.62), epilepsy (adjusted OR 1.37, 95% CI 1.08-1.74) and mood disorders (adjusted OR 1.25, 95% CI 1.11-1.41). The same pattern held for mild forms of congenital heart disease. A higher prevalence of severe congenital heart disease was seen only among offspring of mothers with congenital heart defects or type 2 diabetes.InterpretationThe children of women with several kinds of chronic disease appear to be at risk for congenital heart disease. Preconception counselling and optimum treatment of pregnant women with chronic disease would seem prudent.© 2016 Canadian Medical Association or its licensors.

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