Prenatal risk factors in the occurrence of congenital heart disease
Objective: to determine a relationship of individual risk factors in pregnant women to the occurrence of fetal congenital heart disease. A case-control study was performed in 764 pregnant women. An odds ratio (OR) and 95% confidence intervals (95% CI) were calculated to assess the role of risk factors. The presence of at least one risk factor for fetal heart disease was confirmed in 309 (40,4%) pregnant women. One hundred and fifty-six cases of fetal heart disease was diagnosed in the presence of a risk factor in 61 (8%) cases and in its absence in 95 (12,4%). Hereditary heart disease in her previous child and a pregnant woman herself was not a statistically significant risk factor: OR 1,43; 95% CI, 0,45-3,85; OR 2,67; 95 CI, 0,65-9,74, respectively. Analysis of the ultrasonographic markers of chromosomal abnormalities and threatened miscarriage in the first trimester also showed their low significance. There was no significant relationship between a pregnant woman’s age over 35 years and the risk of fetal heart disease. In vitro fertilization as a risk factor for fetal heart disease was found to have no significant impact. A 2,2-fold increase in the risk of fetal heart disease (OR 2,23; 95 CI, 1,04-4,56) was associated with a pregnant woman’s diseases (acute respiratory viral infection in the first trimester, urogenital or intrauterine infection, etc.). Thus, the investigation of the role of individual risk factors for fetal heart disease has not shown their statistical significance and calls for their further investigation to subsequently elaborate preventive measures.