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Risk factors for congenital heart defects in two populations residing in the same geographic area: a long-term population-based study, Southern Israel

Published online by Cambridge University Press:  09 July 2019

Renana Robinson
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Moshe Stavsky
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
Maayan Yitshak Sade
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
Hanah Krymko
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Department of Pediatric Cardiology, Soroka University Medical Center, Beer-Sheva, Israel
Leonel Slanovic
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Department of Pediatric Cardiology, Soroka University Medical Center, Beer-Sheva, Israel
Victor Novack
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
Maya Atar Vardi
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Arnon Broides*
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel
Aviva Levitas
Affiliation:
Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Department of Pediatric Cardiology, Soroka University Medical Center, Beer-Sheva, Israel
*
Author for correspondence: Arnon Broides M.D., Department of Pediatric Cardiology, Soroka University Medical Center, Beer-Sheva, Israel, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, Tel: +972-54-236-5205. E-mail: broides@bgu.ac.il

Abstract

Background:

Congenital Heart Defects (CHD) are the most common structural defects of newborns. Southern Israel’s population is comprised of Jews (75%) and Arab-Bedouins (25%). The latter has a high rate of consanguinity and low abortion rate compared with the Jewish population, which led us to suspect a higher CHD prevalence in this population. Our aim was to compare maternal risk factors that are associated with CHD in these populations.

Methods:

All births during 1991–2011 in Soroka University Medical Center (n = 247, 289) with 6078 newborns having CHD were included. To account for same-woman deliveries, general estimating equation models adjusted for ethnicity, gender and birth number were used.

Results:

The total prevalence of CHD was 24.6/1000 live births, with 21.4 and 30 among Jewish and Bedouin populations, respectively, (p = 0.001). Multi-variant analysis of risk factors for CHD revealed that risk factors common to both populations included conception with fertility medications, sibling CHD, maternal CHD, diabetes mellitus, hypertension and anaemia. Risk factors that were specific for the Bedouin population were – maternal age over 35 years, recurrent pregnancy loss and in vitro fertilisation. However, sibling CHD was more common as a CHD risk factor in the Jewish compared with the Bedouin population (Adjusted OR 10.23 versus 3.19, respectively).

Conclusions:

The prevalence of CHD is higher in both the Bedouin and Jewish populations than previously reported. Several maternal factors were associated with CHD specifically for a certain population. Risk factors for CHD vary in populations residing in the same geographic area.

Type
Original Article
Copyright
© Cambridge University Press 2019 

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References

Mackie, AS, Pilote, L, Ionescu-Ittu, R, Rahme, E, Marelli, AJ. Health care resource utilization in adults with congenital heart disease. Am J Cardiol 2007; 99: 839843.CrossRefGoogle ScholarPubMed
Mackie, AS, Ionescu-Ittu, R, Pilote, L, Rahme, E, Marelli, AJ. Hospital readmissions in children with congenital heart disease: a population-based study. Am Heart J 2008; 155: 577584.CrossRefGoogle ScholarPubMed
Dolk, H, Loane, M, Garne, E. Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Circulation 2011; 123: 841849.CrossRefGoogle ScholarPubMed
van der Bom, T, Zomer, A. The changing epidemiology of congenital heart disease. Nat Rev Cardiol 2010; 8: 5060.CrossRefGoogle ScholarPubMed
Leirgul, E, Fomina, T, Brodwall, K, Greve, G. Birth prevalence of congenital heart defects in Norway 1994-2009 — A nationwide study. Am Heart J 2009; 168: 956964.CrossRefGoogle Scholar
Ionescu-Ittu, R, Marelli, AJ, Mackie, AS, Pilote, L. Prevalence of severe congenital heart disease after folic acid fortification of grain products: time trend analysis in Quebec, Canada. BMJ 2009; 338: b1673.CrossRefGoogle ScholarPubMed
Dolk, H, Loane, M, Garne, E, Abramsky, L, de Walle, H. Birth prevalence of congenital heart disease. Epidemiology 2010; 21: 275277.CrossRefGoogle ScholarPubMed
Gelb, BD, Chung, WK. Complex genetics and the etiology of human congenital heart disease. Cold Spring Harb Perspect Med 2014; 4: a013953.CrossRefGoogle ScholarPubMed
Jenkins, KJ, Correa, A, Feinstein, J, et al. Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation 2007; 115: 29953014.CrossRefGoogle Scholar
Liu, S, Joseph, KS, Lisonkova, S, et al. Association between maternal chronic conditions and congenital heart defects: a population-based cohort study. Circulation 2013; 128: 583589.CrossRefGoogle ScholarPubMed
Marengo, L, Farag, NH, Canfield, M. Body mass index and birth defects: Texas, 2005–2008. Matern Child Health J 2013; 17: 18981907.CrossRefGoogle ScholarPubMed
Fung, A, Manlhiot, C, Naik, S, et al. Impact of prenatal risk factors on congenital heart disease in the current era. J Am Heart Assoc 2013; 2: e000064.CrossRefGoogle ScholarPubMed
Kurinczuk, JJ, Bower, C. Birth defects in infants conceived by intracytoplasmic sperm injection: an alternative interpretation. BMJ 1997; 315: 12601266.CrossRefGoogle Scholar
Hansen, M, Kurinczuk, JJ, Bower, C, Webb, S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. N Engl J Med 2002; 346: 725730.CrossRefGoogle ScholarPubMed
Calcagni, G, Digilio, MC, Sarkozy, A, Dallapiccola, B, Marino, B. Familial recurrence of congenital heart disease: an overview and review of the literature. Eur J Pediatr 2007; 166: 111116.CrossRefGoogle ScholarPubMed
Øyen, N, Poulsen, G, Boyd, HA, Wohlfahrt, J, Jensen, PKA, Melbye, M. Recurrence of congenital heart defects in families. Circulation 2009; 120: 295301.CrossRefGoogle ScholarPubMed
Gill, HK, Splitt, M, Sharland, GK, Simpson, JM. Patterns of recurrence of congenital heart disease. J Am Coll Cardiol 2003; 42: 923929.CrossRefGoogle ScholarPubMed
Burn, J, Brennan, P, Little, J, et al. Recurrence risks in offspring of adults with major heart defects: results from first cohort of British collaborative study. Lancet 1998; 351: 311316.CrossRefGoogle ScholarPubMed
Ben-Gurion University of the Negev. Statistical Yearbook of the Negev Bedouin. Beer-Sheva, Israel, Ben-Gurion University of the Negev, 2010; Vol. 3: p. 36.Google Scholar
Hoffman, JIE, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 18901900.CrossRefGoogle ScholarPubMed
Zaqout, M, Aslem, ES, Oweida, FS, De Wolf, D. Prevalence of congenital heart disease among Palestinian children born in the Gaza Strip. Cardiol Young. Cambridge University Press 2014; 24: 905909.CrossRefGoogle ScholarPubMed
Shapira, Y, Haklai, Z, Blum, I, Shpack, N, Amitai, Y. Prevalence of non-syndromic orofacial clefts among Jews and Arabs, by type, site, gender and geography: amulti-center study in Israel. Isr Med Assoc J 2014; 16: 759763.Google ScholarPubMed
Yeshayahu, Y, Sagi, A, Silberstein, E. Polydactyly in the multiethnic “Negev” population at southern Israel. J Pediatr Orthop B 2014; 23: 274276.CrossRefGoogle ScholarPubMed
Schott, JJ, Benson, DW, Basson, CT, et al. Congenital heart disease caused by mutations in the transcription factor NKX2-5. Science 1998; 281: 108111.CrossRefGoogle ScholarPubMed
Garg, V, Kathiriya, IS, Barnes, R, et al. GATA4 mutations cause human congenital heart defects and reveal an interaction with TBX5. Nature 2003; 424: 443447.CrossRefGoogle ScholarPubMed
Agay-Shay, K, Friger, M, Linn, S, Peled, A, Amitai, Y, Peretz, C. Air pollution and congenital heart defects. Environ Res 2013; 124: 2834.CrossRefGoogle ScholarPubMed
Loffredo, C., Silbergeld, EK, Ferencz, C, Zhang, J. Association of transposition of the great arteries in infants with maternal exposures to herbicides and rodenticides. Am J Epidemiol 2001; 153: 529536.CrossRefGoogle ScholarPubMed
Karakis, I, Landau, D, Yitshak-Sade, M, et al. Exposure to metals and congenital anomalies: A biomonitoring study of pregnant Bedouin-Arab women. Sci Total Environ 2015; 517: 106112.CrossRefGoogle ScholarPubMed
Øyen, N, Poulsen, G, Boyd, H, Wohlfahrt, J, Jensen, PKA, Melbye, M. National time trends in congenital heart defects, Denmark, 1977–2005. Am Heart J 2009; 157: 467473.e1.CrossRefGoogle Scholar
Sheppard, C, Platt, LD. Nuchal translucency and first trimester risk assessment: a systematic review. Ultrasound Q 2007; 23: 107116.CrossRefGoogle ScholarPubMed