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Potential risk factors for Ebstein anomaly, National Birth Defects Prevention Study, 1997–2011

Published online by Cambridge University Press:  04 June 2019

Karrie F. Downing Open the ORCID record for Karrie F. Downing [Opens in a new window] ,
Tiffany Riehle-Colarusso ,
Suzanne M. Gilboa ,
Angela E. Lin ,
Matthew E. Oster ,
Sarah C. Tinker ,
Sherry L. Farr  and
the National Birth Defects Prevention Study
Karrie F. Downing*
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
Tiffany Riehle-Colarusso
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Suzanne M. Gilboa
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Angela E. Lin
Affiliation:
Medical Genetics Unit, MassGeneral Hospital for Children, Boston, MA, USA
Matthew E. Oster
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
Sarah C. Tinker
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Sherry L. Farr
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
the National Birth Defects Prevention Study
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA Medical Genetics Unit, MassGeneral Hospital for Children, Boston, MA, USA Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
*
Author for correspondence: Karrie F. Downing, MPH, 4770 Buford Hwy, Mailstop S106-3, Atlanta, GA 30341, USA. Tel: +1 404 498 0710; Fax: +1 404 498 3040; Email: yyx9@cdc.gov
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Abstract

Background:

Ebstein anomaly is a rare congenital heart defect (CHD) that, when severe, requires corrective surgery or other catheter-based intervention in the first year of life. Due to its rarity, risk factors for Ebstein anomaly remain largely unknown. Using national data, we examined 18 potential risk factors for Ebstein anomaly.

Methods:

Using 1997–2011 data from the National Birth Defects Prevention Study, a population-based case–control study, we calculated crude and adjusted odds ratios and 95% confidence intervals for paternal age, maternal socio-demographics, reproductive history, and modifiable risk factors, and infant characteristics reported by mothers of 135 Ebstein anomaly cases and 11,829 controls.

Results:

Mothers of Ebstein anomaly cases had 4.1 (95% confidence interval: 1.8, 9.5) times the odds of reporting a family history of CHD compared with mothers of controls. Ebstein anomaly was associated with maternal second-hand cigarette smoke exposure at home (odds ratio = 2.2 [95% confidence interval: 1.1, 4.4]), but not maternal cigarette smoking (odds ratio = 1.3 [95% confidence interval: 0.8, 2.1]). Odds were elevated, but the 95% confidence interval included 1.0, for maternal marijuana use (odds ratio = 1.8 [95% confidence interval: 0.9, 3.8]) and paternal age ≥40 years at delivery (odds ratio = 1.9 [95% confidence interval: 1.0, 3.5]).

Conclusions:

Maternal exposure to second-hand cigarette smoke at home and a family history of CHD were associated with elevated odds of Ebstein anomaly. Genetic analyses could clarify the potential heritability of Ebstein anomaly.

Keywords

Ebstein anomalycongenital heart defectrisk factorscase–control studyprenatal exposure
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 6 , June 2019 , pp. 819 - 827
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Copyright
© Cambridge University Press 2019 

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References

Cetta, F, Dearani, JA, O’Leary, PW, Driscoll, DJ. Chapter 38: tricuspid valve disorders: atresia, dysplasia, and Ebstein anomaly. In: Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult. Vol 2, 9th edn. Lippincott Williams & Wilkins, Philadelphia, PA, 2016.Google Scholar
Attenhofer Jost, CH, Connolly, HM, Edwards, WD, Hayes, D, Warnes, CA, Danielson, GK. Ebstein’s anomaly –review of a multifaceted congenital cardiac condition. Swiss Med Wkly 2005; 135: 269–281.Google ScholarPubMed
Correa-Villasenor, A, Ferencz, C, Neill, CA, Wilson, PD, Boughman, JA. Ebstein’s malformation of the tricuspid valve: genetic and environmental factors. The Baltimore–Washington Infant Study Group. Teratology 1994; 50: 137–147.CrossRefGoogle ScholarPubMed
Roberson, DA, Silverman, NH. Ebstein’s anomaly: echocardiographic and clinical features in the fetus and neonate. J Am Coll Cardiol 1989; 14: 1300–1307.CrossRefGoogle ScholarPubMed
Zeng, Z, Zhang, H, Liu, F, Zhang, N. Current diagnosis and treatments for critical congenital heart defects. Exp Ther Med 2016; 11: 1550–1554.CrossRefGoogle ScholarPubMed
Lupo, PJ, Langlois, PH, Mitchell, LE. Epidemiology of Ebstein anomaly: prevalence and patterns in Texas, 1999–2005. Am J Med Genet A 2011; 155a: 1007–1014.CrossRefGoogle ScholarPubMed
Correa-Villasenor, A, McCarter, R, Downing, J, Ferencz, C. White–black differences in cardiovascular malformations in infancy and socioeconomic factors. The Baltimore–Washington Infant Study Group. Am J Epidemiol 1991; 134: 393–402.Google ScholarPubMed
Forrester, MB, Merz, RD. Descriptive epidemiology of selected congenital heart defects, Hawaii, 1986–1999. Paediatr Perinat Epidemiol 2004; 18: 415–424.CrossRefGoogle ScholarPubMed
Knudsen, TM, Hansen, AV, Garne, E, Andersen, AM. Increased risk of severe congenital heart defects in offspring exposed to selective serotonin-reuptake inhibitors in early pregnancy – an epidemiological study using validated EUROCAT data. BMC Pregnancy Childbirth 2014; 14: 333.CrossRefGoogle ScholarPubMed
Caton, AR, Bell, EM, Druschel, CM, et al. Antihypertensive medication use during pregnancy and the risk of cardiovascular malformations. Hypertension 2009; 54: 63–70.CrossRefGoogle ScholarPubMed
Fisher, SC, Van Zutphen, AR, Werler, MM, et al. Maternal antihypertensive medication use and congenital heart defects: updated results from the National Birth Defects Prevention Study. Hypertension 2017; 69: 798–805.CrossRefGoogle ScholarPubMed
Gilboa, SM, Correa, A, Botto, LD, et al. Association between prepregnancy body mass index and congenital heart defects. Am J Obstet Gynecol 2010; 202: 51.e1–.e10.CrossRefGoogle ScholarPubMed
Patorno, E, Huybrechts, KF, Hernandez-Diaz, S. Lithium use in pregnancy and the risk of cardiac malformations. New Engl J Med 2017; 377: 893–894.Google ScholarPubMed
Reefhuis, J, Gilboa, SM, Anderka, M, et al. The National Birth Defects Prevention Study: a review of the methods. Birth Defects Res A Clin Mol Teratol 2015; 103: 656–669.CrossRefGoogle ScholarPubMed
Yoon, PW, Rasmussen, SA, Lynberg, MC, et al. The National Birth Defects Prevention Study. Public Health Rep 2001; 116 Suppl 1: 32–40.CrossRefGoogle ScholarPubMed
Botto, LD, Lin, AE, Riehle-Colarusso, T, Malik, S, Correa, A. Seeking causes: classifying and evaluating congenital heart defects in etiologic studies. Birth Defects Res A Clin Mol Teratol 2007; 79: 714–727.CrossRefGoogle ScholarPubMed
Caspers, KM, Oltean, C, Romitti, PA, et al. Maternal periconceptional exposure to cigarette smoking and alcohol consumption and congenital diaphragmatic hernia. Birth Defects Res A Clin Mol Teratol 2010; 88: 1040–1049.CrossRefGoogle ScholarPubMed
Oyen, N, Poulsen, G, Boyd, HA, Wohlfahrt, J, Jensen, PK, Melbye, M. Recurrence of congenital heart defects in families. Circulation 2009; 120: 295–301.CrossRefGoogle ScholarPubMed
Fesslova, V, Brankovic, J, Lalatta, F, et al. Recurrence of congenital heart disease in cases with familial risk screened prenatally by echocardiography. J Pregnancy 2011; 2011: 368067.CrossRefGoogle ScholarPubMed
Kelle, AM, Qureshi, MY, Olson, TM, Eidem, BW, O’Leary, PW. Familial incidence of cardiovascular malformations in hypoplastic left heart syndrome. Am J Cardiol 2015; 116: 1762–1766.CrossRefGoogle ScholarPubMed
Miller, EA, Manning, SE, Rasmussen, SA, Reefhuis, J, Honein, MA. Maternal exposure to tobacco smoke, alcohol and caffeine, and risk of anorectal atresia: National Birth Defects Prevention Study 1997–2003. Paediatr Perinat Epidemiol 2009; 23: 9–17.CrossRefGoogle ScholarPubMed
Suarez, L, Ramadhani, T, Felkner, M, et al. Maternal smoking, passive tobacco smoke, and neural tube defects. Birth Defects Res A Clin Mol Teratol 2011; 91: 29–33.CrossRefGoogle ScholarPubMed
Caspers, KM, Romitti, PA, Lin, S, Olney, RS, Holmes, LB, Werler, MM. Maternal periconceptional exposure to cigarette smoking and congenital limb deficiencies. Paediatr Perinat Epidemiol 2013; 27: 509–520.10.1111/ppe.12075CrossRefGoogle ScholarPubMed
Hoyt, AT, Canfield, MA, Romitti, PA, et al. Associations between maternal periconceptional exposure to secondhand tobacco smoke and major birth defects. Am J Obstet Gynecol 2016; 215: 613.e1–.e11.10.1016/j.ajog.2016.07.022CrossRefGoogle ScholarPubMed
Zhao, L, Chen, L, Yang, T, et al. Parental smoking and the risk of congenital heart defects in offspring: an updated meta-analysis of observational studies. Eur J Prev Cardiol 2019; 0: 1–10.Google Scholar
Feldkamp, ML, Srisukhumbowornchai, S, Romitti, PA, Olney, RS, Richardson, SD, Botto, LD. Self-reported maternal cigarette smoke exposure during the periconceptional period and the risk for omphalocoele. Paediatr Perinat Epidemiol 2014; 28: 67–73.CrossRefGoogle ScholarPubMed
Su, XJ, Yuan, W, Huang, GY, Olsen, J, Li, J. Paternal age and offspring congenital heart defects: a national cohort study. PloS One 2015; 10: e0121030.CrossRefGoogle ScholarPubMed
Green, RF, Devine, O, Crider, KS, et al. Association of paternal age and risk for major congenital anomalies from the National Birth Defects Prevention Study, 1997 to 2004. Ann Epidemiol 2010; 20: 241–249.10.1016/j.annepidem.2009.10.009CrossRefGoogle ScholarPubMed
Dietz, PM, Homa, D, England, LJ, et al. Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. Am J Epidemiol 2011; 173: 355–359.CrossRefGoogle ScholarPubMed
Cogswell, ME, Bitsko, RH, Anderka, M, et al. Control selection and participation in an ongoing, population-based, case–control study of birth defects: the National Birth Defects Prevention Study. Am J Epidemiol 2009; 170: 975–985.CrossRefGoogle Scholar
Rothman, KJ, Greenland, S, Lash, TL. Modern Epidemiology. 3rd edn. Lippincott Williams & Wilkins, Philadelphia, 2008.Google Scholar