Congenital Heart Defects In Infants Research Articles

Pre-gestational diabetes and the risk of congenital heart defects in the offspring: A French nationwide study

To compare the frequencies and types of congenital heart defects for infants of women without and with pre-gestational diabetes, type 1 and type 2 diabetes (T1DM, T2DM) and to identify risk factors. All live births between 2012 and 2020 were screened for maternal diabetes and infant congenital heart defects using the French Medical Information System Program in Medicine, Surgery and Obstetrics database (PMSI-MCO). Incidences of these defects were estimated, and a logistic model evaluated maternal and fetal prognostic risk factors. Overall, 6,038,703 mothers did not have pre-gestational diabetes (no-diabetes), 23,147 had T1DM, and 14,401 had T2DM. The incidence of infant congenital disease was 6.2% for the no-diabetes group, 8.0%, for women with T1DM, and 8.4% for women with T2DM (P < 0.001); for congenital heart defects, incidences were respectively 0.8%, 3.0% and 2.7% (P < 0.001). In comparison with the no-diabetes group, the odds ratios (95%CI) of coronary heart defects were 2.07 (1.91;2.24) (P < 0.001) for women with T1DM and 2.20 (1.99;2.44) (P < 0.001) for women with T2DM, with no difference between T1DM and T2DM (P=0.336). cesarian section, small and large for gestational age, and prematurity were also associated with an increased risk of congenital heart defects. In this study we observed higher incidences of congenital heart defects in infants of women with pre-gestational diabetes compared to women without pre-gestational diabetes, with no difference between women with T1DM or T2DM. These data call for intensifying preconception care and justify systematic cardiac echography in selected fetuses.

Maternal diabetes as a teratogenic factor for congenital heart defects in infants of diabetic mothers.

Congenital heart defects (CHDs) are shown to have an association with maternal diabetes mellitus. The Bahraini population has a high prevalence of diabetes 16.3% thus putting it at increased risk of developing CHDs in infants of diabetic mothers (IDMs). Describing the prevalence of CHDs in IDM in the Kingdom of Bahrain. A retrospective clinical study. Bahrain Defense Force Hospital, Kingdom of Bahrain. The study took place from January 1998 to January 2020. A history was recorded for all patients who were referred to the only tertiary cardiac center in Bahrain for echocardiography. Data was recorded on an Excel Sheet for analysis. A cardiac anatomy survey was conducted by an experienced pediatric cardiologist for each patient and the defects were categorized into acyanotic and cyanotic lesions. Five thousand five hundred sixty-nine patients were referred for cardiac echocardiography. Three thousand two hundred fifty-six patients were diagnosed with CHDs, 2,987 were non-IDM whereas 269 were IDM. Patients diagnosed with non-structural defects were excluded. Atrial septal defect (ASD) was identified in 744 patients and was more likely to occur in non-IDM (p-value=.005). Hypertrophic obstructive cardiomyopathy (HOCM) was identified in 35 patients and was more likely to occur in IDM (p-value < .001). Transposition of the great arteries (TGAs) was identified in 80 patients and was more likely to occur in IDM (p-value .002). Double inlet left ventricle (DILV), Hypoplastic Left Heart Syndrome (HPLHS), and Other Uni-Ventricular Hearts were all more likely to occur in IDM with p-values < .05. This study showed significant association between fetal exposure to diabetes and the development of ASD, HOCM, TGA, DILV, HPLHS, and Other Uni-Ventricular Hearts.

Prevalence of congenital heart defects in infants of diabetic mothers in Aseer region, Southwestern, Saudi Arabia

Background: Maternal diabetes mellitus is a risk factor for adverse maternal and fetal outcomes, including anatomical malformations such as congenital heart defects (CHD). Objectives: To determine the prevalence of CHD in babies born to mothers with pre-existing or gestational diabetes. Patients and Methods: A retrospective study of all births of type 1, type 2 diabetic mothers, gestational diabetic mothers, and non-diabetic mothers admitted to the newborn nursery and the neonatal intensive care unit between July 2011 and June 2022 was performed. Results: A total of 2079 mothers and their offspring were enrolled in the study. Of 2079 mothers 1397 (67.2%) were non-diabetic and 682 (32.8%) were diabetic. In terms of diabetic status, the incidence of cardiovascular anomalies in infants of diabetic mothers is significantly higher than the infants of non-diabetic mothers (p

Frequency of Congenital Heart Defects in Infants and Young Children Based on Echocardiography at a Children’s Hospital in Lahore

Frequency of Congenital Heart Defects in Infants and Young Children Based on Echocardiography at a Children’s Hospital in Lahore

Maternal psychological distress, education, household income, and congenital heart defects: a prospective cohort study from the Japan environment and children\u2019s study

BackgroundThe influence of maternal psychological distress on infant congenital heart defects (CHDs) has not been thoroughly investigated. Furthermore, there have been no reports on the combined effect of maternal psychological distress and socioeconomic status on infant CHDs. This study aimed to examine whether maternal psychological distress, socioeconomic status, and their combinations were associated with CHD.MethodsWe conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women between 2011 and 2014. Maternal psychological distress was evaluated using the Kessler Psychological Distress Scale in the first trimester, while maternal education and household income were evaluated in the second and third trimesters. The outcome of infant CHD was determined using the medical records at 1 month of age and/or at birth. Crude- and confounder-adjusted logistic regression analyses were performed to evaluate the association between maternal psychological distress and education and household income on infant CHD.ResultsA total of 93,643 pairs of mothers and infants were analyzed, with 1.1% of infants having CHDs. Maternal psychological distress had a significantly higher odds ratio in the crude analysis but not in the adjusted analysis, while maternal education and household income were statistically insignificant. In the analysis of the combination variable of lowest education and psychological distress, the P for trend was statistically significant in the crude and multivariate model excluding anti-depressant medication, but the significance disappeared in the full model (P = 0.050).ConclusionsThe combination of maternal psychological distress and lower education may be a possible indicator of infant CHD.

Impact of early surgical correction or palliation of congenital heart defects in infants with symptomatic viral respiratory tract infections in the current era

ObjectiveThis study investigates the influence of timing of surgery among infants with congenital heart disease and active respiratory tract infections in a contemporary Western Canadian cohort. MethodsThis was a retrospective matched cohort study of infants aged 1 week to 6 months undergoing surgical repair of congenital heart disease between 2014 and 2017. Case patients had active respiratory tract infections preoperatively and were matched to control patients based on primary heart lesion. The primary outcome was time to extubation. ResultsWe identified 20 cases (median age, 3.4 months [range, 2.4-4.3 months]) that were matched to 40 controls (1:2 ratio). In case patients, surgery occurred at a median of 1 day after the positive viral testing. There were no statistically significant differences between cases and controls in time to extubation (59 vs 34 hours [P = .12]), postoperative vasoactive scores at 24 hours (0 vs 0 [P = .53]), 48 hours (0 vs 0 [P = .23]), maximum vasoactive score in postoperative period (5 vs 5.5 [P = .54]), or time to hospital discharge (13 vs 12 days [P = .39]). Case patients had increased duration of total respiratory support (including noninvasive ventilation, 3.5 vs 2 days [P = .02]) and postoperative intensive care unit length of stay (5.5 vs 3 days [P = .01]). ConclusionsCardiac surgery on infants with congenital heart disease during an acute viral respiratory tract infection may yield a clinically relevant prolongation in time to extubation.

Unintended pregnancy-related factors and the occurrence of offspring congenital heart disease: a multi-site case-control study in China

Objectives The aim of this study was to explore the association between unintended pregnancy and related factors among congenital heart defects (CHDs) in infants. Methods A total of 1197 cases with isolated CHDs and 1125 controls without any abnormalities were analysed in this multicentre study at seven hospitals in China. According to the pregnancy intention, cases were divided into two groups: planned and unintended pregnancies. The adjusted odds ratio (AOR) was calculated by logistic regression analysis to assess the association between unintended pregnancy and CHD occurrence. The time to prepare for pregnancy and the influencing factors were also compared in this article. Results The risk for CHD occurrence was significantly associated with unintended pregnancy (AOR: 1.42; 95%CI: 1.16–1.73), which may increase the risks for each subtype of CHD occurrence. Risks such as parental smoking, housing renovation, accidental alcohol consumption, lack of health check-ups, and no folic acid supplementation before pregnancy were distributed differently among the planned and unintended pregnancy groups and were associated with CHD occurrence. However, there was no significant association between the duration of planned pregnancy and the risk of CHDs. Conclusions Unintended pregnancy increased the risk of CHDs in infants. This risk may be related to some known and unknown factors. Synopsis Some unintended pregnancy related factors may increase the risk for foetal CHDs. The duration of planning pregnancy may not be associated with the risk of CHDs.

Identifying genetic factors that contribute to the increased risk of congenital heart defects in infants with Down syndrome

Atrioventricular septal defects (AVSD) are a severe congenital heart defect present in individuals with Down syndrome (DS) at a > 2000-fold increased prevalence compared to the general population. This study aimed to identify risk-associated genes and pathways and to examine a potential polygenic contribution to AVSD in DS. We analyzed a total cohort of 702 individuals with DS with or without AVSD, with genomic data from whole exome sequencing, whole genome sequencing, and/or array-based imputation. We utilized sequence kernel association testing and polygenic risk score (PRS) methods to examine rare and common variants. Our findings suggest that the Notch pathway, particularly NOTCH4, as well as genes involved in the ciliome including CEP290 may play a role in AVSD in DS. These pathways have also been implicated in DS-associated AVSD in prior studies. A polygenic component for AVSD in DS has not been examined previously. Using weights based on the largest genome-wide association study of congenital heart defects available (2594 cases and 5159 controls; all general population samples), we found PRS to be associated with AVSD with odds ratios ranging from 1.2 to 1.3 per standard deviation increase in PRS and corresponding liability r2 values of approximately 1%, suggesting at least a small polygenic contribution to DS-associated AVSD. Future studies with larger sample sizes will improve identification and quantification of genetic contributions to AVSD in DS.

Engineering Myocardium for Heart Regeneration-Advancements, Considerations, and Future Directions.

Heart disease is the leading cause of death in the United States among both adults and infants. In adults, 5-year survival after a heart attack is <60%, and congenital heart defects are the top killer of liveborn infants. Problematically, the regenerative capacity of the heart is extremely limited, even in newborns. Furthermore, suitable donor hearts for transplant cannot meet the demand and require recipients to use immunosuppressants for life. Tissue engineered myocardium has the potential to replace dead or fibrotic heart tissue in adults and could also be used to permanently repair congenital heart defects in infants. In addition, engineering functional myocardium could facilitate the development of a whole bioartificial heart. Here, we review and compare in vitro and in situ myocardial tissue engineering strategies. In the context of this comparison, we consider three challenges that must be addressed in the engineering of myocardial tissue: recapitulation of myocardial architecture, vascularization of the tissue, and modulation of the immune system. In addition to reviewing and analyzing current progress, we recommend specific strategies for the generation of tissue engineered myocardial patches for heart regeneration and repair.

Cardiac Surgery in Trisomy 13 and 18: A Guide to Clinical Decision-Making.

There has been substantial controversy regarding treatment of congenital heart defects in infants with trisomies 13 and 18. Most reports have focused on surgical outcomes versus expectant treatment, and rarely there has been an effort to consolidate existing evidence into a more coherent way to help clinicians with decision-making and counseling families. An extensive review of the existing literature on cardiac surgery in patients with these trisomies was conducted from 2004 to 2020. The effects of preoperative and perioperative factors on in-hospital and long-term mortality were analyzed, as well as possible predictors for postoperative chronic care needs such as tracheostomy and gastrostomy. Patients with minimal or no preoperative pulmonary hypertension and mechanical ventilation undergoing corrective surgery at a weight greater than 2.5kg suffer from lower postoperative mortality. Infants with lower-complexity cardiac defects are likely to benefit the most from surgery, although their expected mortality is higher than that of infants without trisomy. Omphalocele confers an increased mortality risk regardless of cardiac surgery. Gastrointestinal comorbidities increased the risk of gastrostomy tube placement, while those with prolonged mechanical ventilation and respiratory comorbidities are more likely to require tracheostomy. Cardiac surgery is feasible in children with trisomies 13 and 18 and can provide improved long-term results. However, this is a clinically complex population, and both physicians and caretakers should be aware of the long-term challenges these patients face following surgery when discussing treatment options.

Maternal residential greenness and congenital heart defects in infants: A large case-control study in Southern China

BackgroundProximity to greenness has shown protective effects on coronary heart diseases by limiting exposure to environmental hazards, encouraging physical activity, and reducing mental stress. However, no studies have previously evaluated the impacts of greenness on congenital heart defects (CHDs). We examined the association between maternal residential greenness and the risks of CHDs. MethodsWe conducted a case-control study (8042 children with major CHDs and 6887 controls without malformations) in 21 cities in Southern China, 2004 – 2016. CHDs cases were diagnosed and verified by obstetrician, pediatrician, or pediatric cardiologists, within one year. We estimated maternal residential greenness using satellite-derived normalized difference vegetation index (NDVI) in zones of 500 meters (m) and 1000 m surrounding participants’ residences. Logistic regression models were used to assess NDVI-CHD relationships adjusting for confounders. ResultsInterquartile range NDVI increases within 500 m or 1000 m were associated with odds ratios (OR) of 0.95 (95% confidence interval (CI): 0.92, 0.98) and 0.94 (95%CI: 0.91, 0.97) for total CHDs respectively. Air pollutants mediated 52.1% of the association. We also identified a protective threshold at 0.21 NDVI on CHD. Similar protective effects from greenness were found in most CHDs subtypes. The protective associations were stronger for fall, urban or permanent residents, higher household income maternal age ≤35 years of age, and high maternal education (ORs: ranged from 0.85 to 0.96). ConclusionOur findings suggest a beneficial effect of maternal residential greenness on CHDs. Further studies are needed to confirm our findings, which will help to refine preventive health and urban design strategies.

High maternal selenium levels are associated with increased risk of congenital heart defects in the offspring.

To examine whether maternal hair or cord blood selenium levels are associated with infant congenital heart defects (CHDs). A hospital-based case-control study was performed with samples collected from 2010 to 2014. Selenium levels in maternal hair and fetal cord serum were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Data from medical records of infants with CHDs were collected. Logistic regression analysis was employed to examine the independent association between maternal selenium exposure and fetal CHD. In total, 888 pregnant women were included in this study. Median (interquartile range) selenium levels in of maternal hair was similar in the control and CHD group. A significant association was detected between increased maternal hair selenium concentration and CHDs in offspring (adjusted odds ratio [aOR] 3.57, 95 %CI, 1.90-6.70). The association was present in all CHD groups, including septal defects, conotruncal defects, left ventricular outflow tract obstruction, right ventricular outflow tract obstruction, and anomalous pulmonary venous return. High maternal selenium level is significantly associated with the occurrence of fetal CHD.

Maternal risk factors for congenital heart defects in infants with Down syndrome from Western Mexico.

Atrioventricular septal defects (AVSDs) have been identified as intriguingly infrequent among Hispanics with Down syndrome (DS) born in the United States. The aim of this study was to evaluate the effect of possible maternal risk factors in the presence of congenital heart defects (CHDs) in Mexican infants with DS. A total of 231 live birth infants born with DS during 2009-2018 at the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Guadalajara, Mexico) were ascertained in a case-control study. Patients with DS with any major CHD were included as cases and those without major CHD as controls. Potential risk factors were analyzed using logistic regression. Of eligible infants with DS, 100 (43.3%) had ≥1 major CHDs (cases) and were compared with a control group of 131 infants (56.7%) with DS without CHDs. Prevalent CHDs were ostium secundum atrial septal defects (ASDs) (46.9%), ventricular septal defects (27.3%), and AVSDs (14%). Lack of folic acid supplementation before pregnancy had a significant risk for CHDs in infants with DS (adjusted odds ratio [aORs] = 2.9 (95% confidence interval [95% CI]: 1.0-8.6) and in the analysis by subtype of CHDs, also, for the occurrence of ASDs (aOR = 11.5, 95% CI: 1.4-94.4). Almost half of the infants with DS in our sample had CHDs, being ASD the commonest subtype and AVSD the rarest. Our ethnic background alone or in concomitance with observed nutritional disadvantages seems to contribute differences in CHD subtype rates in our DS patients.

Maternal Body Mass Index and Risk of Congenital Heart Defects in Infants: A Dose-Response Meta-Analysis.

Objective The exact shape of the dose-response relationship between maternal body mass index (BMI) and the risk of congenital heart defects (CHDs) in infants has not been clearly defined yet. This study aims to further clarify the relationship between maternal obesity and the risk of CHDs in infants by an overall and dose-response meta-analysis. Methods PubMed, Embase, and Web of Science databases were searched to identify all related studies. The studies were limited to human cohort or case-control studies in English language. Random-effect models and dose-response meta-analysis were used to synthesize the results. Heterogeneity, subgroup analysis, sensitivity analysis, and publication bias were also assessed. Results Nineteen studies with 2,416,546 participants were included in our meta-analysis. Compared with the mothers with normal weight, the pooled relative risks (RRs) of infants with CHDs were 1.08 (95% CI=1.03-1.13) in overweight and 1.23 (95% CI=1.17-1.29) in obese mothers. According to the findings from the linear meta-analysis, we observed an increased risk of infants with CHDs (RR=1.07, 95% CI=1.06-1.08) for each 5 kg/m2 increase in maternal BMI. A nonlinear relationship between maternal BMI and risk of infants with CHDs was also found (p=0.012). Conclusion The results from our meta-analysis indicate that increased maternal BMI is related to increased risk of CHDs in infants.

Tissue Oxygenation During Treatment of Infant Congenital Heart Defects

Tissue Oxygenation During Treatment of Infant Congenital Heart Defects

Critical appraisal of MAPSE and TAPSE usefulness in the postoperative assessment of ventricular contractile function after congenital heart defect surgery in infants.

IntroductionIn this study, we assessed the adequacy of the two echocardiographic parameters representing the longitudinal systolic function of the ventricles, MAPSE & TAPSE, in perioperative monitoring.Aims1. The assessment of MAPSE and TAPSE during the early (4 weeks) postoperative period after surgical correction of congenital heart defects in infants, performed with CPB. 2. The verification of the hypothesis, that the significant decline of TAPSE observed in this period is not related to the global RV systolic dysfunction. For this reason, systolic function of the RV was additionally assessed with another echocardiographic parameter: RVFAC.Material and methodsProspective study with 51 infants operated due to ASDII, VSD, AVSD and TOF. Four measurements of MAPSE,TAPSE and RVFAC were performed in the apical four-chamber projection. TAPSE and MAPSE were expressed as metric values and z-score; RV FAC values were expressed in percentages.ResultsTAPSE uniformly declined in the first postoperative day down to 34.5% of the initial value (p <0.00001), then gradually increased: up to 42.9% and 52% respectively, remaining significantly lower than preoperatively (p <0.001). RV FAC: increased by 21% (p <0.01), then remained stable in consecutive examinations. MAPSE declined by 21% during the first postoperative day, but with promptly normalized completely.ConclusionsThe movement of both AV valve annuli is subjected to different, not fully understood influences. The relatively slight decline of MAPSE makes this parameter suitable for the assessment of the postoperative LV systolic function. Deep, long-lasting decline of TAPSE, uniform in the whole group, does not permit to use this parameter and suggests the choice of another one, e.g. RVFAC.

Cardiac findings in infants with in utero exposure to Zika virus- a cross sectional study.

BackgroundAntenatal exposure to Zika virus (ZIKV) is related to severe neurological manifestations. A previous study in Brazil reported an increased incidence of non-severe congenital heart defects in infants with diagnosis of congenital Zika syndrome but without laboratory confirmation of ZIKV infection in the mother or infant. The objective of this study is to report echocardiographic (ECHO) findings in infants with laboratory confirmed antenatal exposure to ZIKV.MethodologyCross sectional study of cardiologic assessments of infants born between November 2015 and January 2017 with confirmed vertical exposure to ZIKV in Rio de Janeiro, Brazil.ResultsThe study enrolled 120 children with a median age of 97 days (1 to 376 days). In utero exposure to ZIKV was confirmed in 97 children (80,8%) through positive maternal polymerase chain reaction (PCR) results during pregnancy or a positive PCR result at birth; 23 additional children (19.2%) had maternal positive PCR results during pregnancy and postnatally. Forty- eight infants (40%) had cardiac defects noted on ECHO. Thirteen infants (10.8%) had major cardiac defects (atrial septal defect, ventricular septal defect, patent ductus arteriosus). None of the defects were severe. The frequency of major defects was higher in infants whose mothers had a rash in the 2nd trimester of pregnancy, or who had altered Central Nervous System (CNS) imaging postnatally or were preterm.ConclusionsInfants with in utero ZIKV exposure have a higher prevalence of major cardiac defects, however none were severe enough to require immediate intervention. For this reason, guidelines for performance of postnatal ECHO in this population should follow general newborn screening guidelines, which significantly reduces the burden of performing emergent fetal or neonatal ECHOs in a setting where resources are not available, such as most Brazilian municipalities.

Association between maternal body mass index and congenital heart defects in infants: A meta-analysis

We conducted this meta-analysis to address the open question of a possible association between maternal body mass index (BMI) and congenital heart defects (CHDs) in infants. We conducted a comprehensive computerized search of PubMed, Web of Science, Medline, and Embase databased (January 1980 through August 2017). We assessed the association between maternal BMI and the risk for congenital heart defects in their offspring. Study-specific relative risk estimates were polled according to random-effect or fixed-effect models. From 2567 citations, a total of 13 case-control studies and 4 cohort studies were selected for a meta-analysis, including more than 1150000 cases. The pooled odds radio (OR) of 1.065 (95% confidence interval [CI], 1.021-1.100; P = .001; I2 = 60.1%) indicated a positive effect of maternal overweight status (BMI 25.0-29.9 kg/m2 ) on the risk for congenital heart defects in infants. Moreover, we observed a significant association between maternal obesity (BMI ≥ 30 kg/m2 ) and congenital heart defects in their offspring (OR: 1.174; 95% CI, 1.146-1.203, P = 0.161; I2 =25.5%). However, there was little significant evidence of an association between maternal underweight status (BMI < 18.5 kg/m2 ) and offspring with congenital heart defects, and the pooled OR was 1.015 (95% CI, 0.980-1.052; P = 0.085; I2 =34.0%). Our meta-analysis provides robust evidence of the positive association between maternal BMI and the risk for fetal congenital heart defects.

Influence factors of extubation failure following surgical repair of congenital heart defects in infants

Objective To investigate the risk factors of extubation failure following surgical repair of congenital heart defects (CHD) in infants. Methods Infantile patients who underwent surgical repair of CHD under cardio-pulmonary bypass (CPB) in the First Affiliated Hospital of Sun Yat-Sen University from January 2015 to October 2016 were included.According to results of extubation, the patients were divided into the extubation failure group and extubation success group.Clinical and laboratory data were collected and analyzed, including age, gender, body mass, the types of congenital heart disease, extracorporeal circulation time and the use of vasoactive drug, et al. Results Sixty cases were enrolled in this study.Among them 12 cases (7 males, 5 females with the boy to girl ratio of 1.4∶1.0, and average age was 0.56 years old) were in the extubation failure group, in which 3 cases (25.0%) aged 5-10 kg.Forty-eight cases(27 males, 21 females; the boy to girl ratio was 1.2∶1.0 and average age was 1.15 years old) were in the extubation success group.The distribution of age and body weight were significantly lower in the extubation failure group than those in the extubation success group[0.42 (0.37) years old vs.1.00 (1.08) years old, Z=-3.22, P 0.05). Multiple Logistic regression showed that the duration of CPB was an independent risk factor of extubation failure[odds ratio (OR)=0.967, 95% CI: 0.956-0.997, P=0.024]. Conclusions The risk factors of extubation failure include young age, low body weight, and prolonged CPB and mechanical ventilation.CPB time is an independent risk factor of extubation failure following cardiac surgery in infants. Key words: Infant; Congenital heart disease; Postoperative; Extubation failure; Risk factor

Association Between Preeclampsia and Congenital Heart Defects

(JAMA. 2015;314(15):1588–1598) Congenital heart defects are the most common anomaly in infants and are a major cause of infant morbidity and mortality. The origins of congenital heart defects, therefore, need to be better studied in order to improve prevention and earlier detection. Recent studies have tried to identify biomarkers for congenital heart defects as well as preeclampsia. Biomarker findings associated with heart defects include imbalances in proangiogenic signaling proteins, such as vascular endothelial growth factor and placental growth factor, and antiangiogenic proteins, such as soluble endoglin and fms-like tyrosine kinase 1. Imbalances in these same biomarkers have been found with preeclampsia, where there is an excess of soluble endoglin and fms-like tyrosine kinase 1 relative to placental growth factor and vascular endothelial growth factor. Angiogenic mechanisms may be part of a shared pathologic pathway for preeclampsia and congenital heart defects. Studies have shown that the pathologic changes associated with preeclampsia begin early in pregnancy, around the time that fetal heart development is occurring. This current study tried to determine the relationship between preeclampsia and the prevalence of congenital heart defects in infants whose mothers had the disorder.