Geographical variations in maternal lifestyles during pregnancy associated with congenital heart defects among live births in Shaanxi province, Northwestern China

Yini Liu,Leilei Pei,Jing Li,Huihui Zhang,Duolao Wang,Fangyao Chen,Chujun Liang,Yaling Zhao

doi:10.1038/s41598-020-69788-0

Yini Liu, Leilei Pei + Show 6 more

Open Access

https://doi.org/10.1038/s41598-020-69788-0

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Abstract

In this study, we aimed to explore regional differences in maternal lifestyle during pregnancy related to congenital heart defects (CHD) in Shaanxi province, Northwestern China. A large-scale epidemiologic survey of birth defects among infants born during 2010–2013, was conducted in Shaanxi province. Non-spatial and geographic weighted logistic regression models were used for analysis. The spatial model indicated that passive smoking frequency was positively associated with CHD for 43.3% of participants (P < 0.05), with the highest OR in North Shaanxi and the lowest in South Shaanxi. Approximately 49.2% of all mothers who ever drink tea were more likely to have an infant with CHD (P < 0.05), with the highest OR values observed in North and Central Shaanxi. Additionally, maternal alcohol intake frequency ≥ 1/week was significantly correlated with CHD among about 24.7% of participants (P < 0.05), with OR values ranging from 0.738 (Central Shaanxi) to 1.198 (North Shaanxi). The rates of unhealthy maternal lifestyles during pregnancy associated with CHD differed in various areas of the province. The role of geographical variations in these factors may provide some possible clues and basis for tailoring site-specific intervention strategies.

Highlights

Congenital heart disease (CHD), a serious structural abnormality of the heart or large blood vessels in the intrathoracic, is one of the most common types of birth defects (BD) globally[1,2]
We used the Geographically Weighted Logistic Regression (GWLR) model to generate local coefficients to account for geographical variations in evaluating the correlation between congenital heart defects (CHD) in infants and maternal lifestyles during pregnancy
This geographically weighted regression model was helpful in identifying distinct patterns that appeared in different villages and townships, so that we could clearly visualize differences in maternal lifestyles during pregnancy related to CHD among disparate regions

Summary

Introduction

Congenital heart disease (CHD), a serious structural abnormality of the heart or large blood vessels in the intrathoracic, is one of the most common types of birth defects (BD) globally[1,2]. Due to extremely unbalanced economic development and huge differences in socio-culture among Shaanxi regions, maternal lifestyle during pregnancy is inevitably disparate across different surveyed areas, and spatial heterogeneity may play an important role in the correlation between the incidence of CHD and maternal lifestyles during pregnancy. GWLR allows for the examination of local changes and provides a map for the visualization of spatial heterogeneity[21] This geographically weighted regression model was helpful in identifying distinct patterns that appeared in different villages and townships, so that we could clearly visualize differences in maternal lifestyles during pregnancy related to CHD among disparate regions. The current study aimed to (1) describe the geographic distribution of maternal lifestyles during pregnancy across different regions, (2) and explore the spatially varying relationship between maternal lifestyles during pregnancy and CHD adjusting for other possible confounding factors

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