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Preeclampsia increased risk of Congenital Heart Defects by 60 percent (vitamin D not mentioned) Oct 2015

Association Between Preeclampsia and Congenital Heart Defects

JAMA. 2015;314(15):1588-1598. doi:10.1001/jama.2015.12505.

Natalie Auger, MD, MSc, FRCPC1,2,3; William D. Fraser, MD, MSc, FRCSC3,4; Jessica Healy-Profitós, MPH1,3; Laura Arbour, MD, MSc, FRCPC, FCCMG5
[+] Author Affiliations
1Institut national de santé publique du Québec, Montreal, Quebec, Canada
2Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
3University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
4Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
5Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada

Importance The risk of congenital heart defects in infants of women who had preeclampsia during pregnancy is poorly understood, despite shared angiogenic pathways in both conditions.

Objective To determine the prevalence of congenital heart defects in offspring of women with preeclampsia.

Design, Setting, and Participants Population-level analysis of live births before discharge, 1989-2012, was conducted for the entire province of Quebec, comprising a quarter of Canada’s population. All women who delivered an infant with or without heart defects in any Quebec hospital were included (N = 1 942 072 neonates).

Exposures Preeclampsia or eclampsia with onset before or after 34 weeks of gestation.

Main Outcomes and Measures Presence of any critical or noncritical congenital heart defect detected in infants at birth, comparing prevalence in those exposed and not exposed to preeclampsia.

Results The absolute prevalence of congenital heart defects was higher for infants of women with preeclampsia (16.7 per 1000 [1219/72 782]) than without it (8.6 per 1000 [16 077/1 869 290]; prevalence ratio [PR], 1.57; 95% CI, 1.48 to 1.67). Infants of preeclamptic women had no increased prevalence of critical heart defects (123.7 vs 75.6 per 100 000 [90/72 782 vs 1414/1 869 290]; PR, 1.25; 95% CI, 1.00 to 1.57; prevalence difference [PD], 23.6 per 100 000; 95% CI, −1.0 to 48.2) but did have an increased prevalence of noncritical heart defects (1538.8 vs 789.2 per 100 000 [1120/72 782 vs 14 752/1 869 290]; PR, 1.56; 95% CI, 1.47 to 1.67; PD, 521.1 per 100 000; 95% CI, 431.1 to 611.0) compared with infants of nonpreeclamptic women. Among specific defects, prevalence was greatest for septal defects. When stratified by variant of preeclampsia, infants of women with early onset (<34 weeks) preeclampsia had greater prevalence of critical heart defects (364.4 per 100 000 [20/5488]; PR, 2.78; 95% CI, 1.71-4.50; PD, 249.6 per 100 000; 95% CI, 89.7-409.6) and noncritical heart defects (7306.9 per 100 000 [401/5488]; PR, 5.55; 95% CI, 4.98-6.19; PD, 6089.2 per 100 000; 95% CI, 5350.0-6828.3), whereas infants of women with late onset (≥34 weeks) did not.

Conclusions and Relevance In this population-based study, preeclampsia was significantly associated with noncritical heart defects in offspring, and preeclampsia before 34 weeks was associated with critical heart defects. However, the absolute risk of congenital heart defects was low.

See also VitaminDWiki

Pages listed in BOTH the categories Pregnancy and Hypertension (preeclampsia)