Abstract
BackgroundPrevious studies have suggested that maternal stress could increase the risk of some adverse pregnancy outcomes, but evidence on congenital heart disease (CHD) is limited. We aimed to explore the association between maternal exposure to life events during pregnancy and CHD in offspring.MethodsThe data was based on an unmatched case-control study about CHD conducted in Shaanxi province of China from 2014 to 2016. We included 2280 subjects, 699 in the case group and 1581 in the control group. The cases were infants or fetuses diagnosed with CHD, and the controls were infants without any birth defects. The life events were assessed by the Life Events Scale for Pregnant Women, and were divided into positive and negative events for synchronous analysis. A directed acyclic graph was drawn to screen the confounders. Logistic regression was employed to estimate the odds ratio and 95% confidence interval for the effects of life events on CHD.ResultsAfter controlling for the potential confounders, the pregnant women experiencing the positive events during pregnancy had lower risk of CHD in offspring than those without positive events (OR = 0.38, 95%CI: 0.30 ~ 0.48). The risk of CHD in offspring could increase by 62% among the pregnant women experiencing the negative events compared to those without (OR = 1.62, 95%CI: 1.29 ~ 2.03). Both effects showed a certain dose-response association. Besides, the positive events could weaken the risk impact of negative events on CHD.ConclusionIt may suggest that maternal exposure to negative life events could increase the risk of CHD in offspring, while experiencing positive events could play a potential protective role.
Highlights
Previous studies have suggested that maternal stress could increase the risk of some adverse pregnancy outcomes, but evidence on congenital heart disease (CHD) is limited
The cases were included according to the following inclusion criteria: the perinatal infants who were diagnosed with CHD according to the International Classification of Diseases-10 (ICD-10) from 28 weeks of gestation to 7 days after birth, as well as the fetuses who were diagnosed with CHD by ultrasound examination in hospital less than 28 weeks of gestation
It meant that the sample size included in our study could provide sufficient power to explore the association between exposure to life events and CHD in offspring
Summary
Previous studies have suggested that maternal stress could increase the risk of some adverse pregnancy outcomes, but evidence on congenital heart disease (CHD) is limited. About 4 to 13 per 1000 live births suffer from CHD around the world [1,2,3]. It is the most common type of birth defects, accounting for about 28% [1]. According to the report on prevention and treatment of birth defects in China [4], the incidence was 4.95 per 1000 live births in 2011, and cases of CHD accounted for 26.7% of all monitored cases of birth defects. Due to the large population base of China, the total number of
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