Parental mean ages and birth order in different types of congenital heart defects.

Abstract

This study has shown that in some of the most common congenital cardiac malformations, such as valvular aortic stenosis, coarctation of the aorta, pulmonary stenosis, atrial and ventricular septal defect and tetralogy of Fallot the mean parental age and the birth order are not involved in the genesis of these lesions. A birth-order effect was only found in patent ductus arteriosus. First-born children are significantly affected more often than later-born siblings. The maternal as well as the paternal mean age is lower in this cardiac lesion. This suggests toward causative factors which may be present mainly during the first pregnancy and in primogenitures. Hypoxia could be one of these factors. If is postulated that in the presence of a polygenetically determined predisposition to this condition hypoxia may prevent closure of the ductus arteriosus. These investigations show that the original method of Haldane-Smith cannot be used for the analysis of the birth order effects on congenital malformations of the heart since the sibships are often incomplete. A corrective method described by Vogel is a good aid for such investigations.