Associated factors for prenatally diagnosed fetal congenital heart diseases

OBJECTIVE: Current studies have suggested that fetal congenital heart diseases (CHDs) are caused by various factors. However, few data in this field is available in China. This study aimed to detect associated factors of prenatally diagnosed fetal CHD in a large sample in China. STUDY DESIGN: Pregnant women who underwent fetal echocardiography were recruited in our hospital between May 2018 and September 2019. The maternal sociodemographic and lifestyle characteristics and some fetal factors were obtained. We used forward stepwise logistic regression analysis to assess risk of fetal CHD associated with various factors. RESULTS: A total of 5024 subjects were enrolled, of whom 875 had CHD fetuses. Among the fetal CHD group (N = 875), critical CHDs account for 27%, of which Tetralogy of Fallot is the most (7.1%), followed by coarctation of aorta (4.0%), double-outlet right ventricle (2.9%). The forward stepwise logistic regression models revealed that history of spontaneous abortion (OR = 1.59, 95% CI 1.33–1.91, P = 0.000), upper respiratory tract infection during early pregnancy (OR = 1.30, 95% CI 1.04–1.62, P = 0.020), mental stress during early pregnancy (OR = 2.37, 95% CI 1.15–4.91, P = 0.020), single umbilical artery (OR = 2.30, 95% CI 1.18–4.51, P = 0.015), and paternal smoking (OR = 1.21, 95% CI 1.02–1.44, P = 0.027) are positively associated with an increased risk of fetal CHD. CONCLUSION: We identified several factors positively associated with fetal CHD. These findings suggest that it is important to strengthen healthcare and prenatal counseling for women with these factors.