Cited by 844Congenital Heart Disease StudiesCongenital heart defects researchPrenatal Substance Exposure Effects

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Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young: Endorsed by the American Academy of Pediatrics

Jenkins, Kathy J., Correa, Adolfo, Feinstein, Jeffrey A., Botto, Lorenzo, Britt, Amy E., Daniels, Stephen R., Elixson, Marsha, Warnes, Carole A., Webb, Catherine L.·2007·Circulation

DOI 10.1161/circulationaha.106.183216

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Abstract

Prevention of congenital cardiovascular defects has been hampered by a lack of information about modifiable risk factors for abnormalities in cardiac development. Over the past decade, there have been major breakthroughs in the understanding of inherited causes of congenital heart disease, including the identification of specific genetic abnormalities for some types of malformations. Although relatively less information has been available on noninherited modifiable factors that may have an adverse effect on the fetal heart, there is a growing body of epidemiological literature on this topic. This statement summarizes the currently available literature on potential fetal exposures that might alter risk for cardiovascular defects. Information is summarized for periconceptional multivitamin or folic acid intake, which may reduce the risk of cardiac disease in the fetus, and for additional types of potential exposures that may increase the risk, including maternal illnesses, maternal therapeutic and nontherapeutic drug exposures, environmental exposures, and paternal exposures. Information is highlighted regarding definitive risk factors such as maternal rubella; phenylketonuria; pregestational diabetes; exposure to thalidomide, vitamin A cogeners, or retinoids; and indomethacin tocolysis. Caveats regarding interpretation of possible exposure-outcome relationships from case-control studies are given because this type of study has provided most of the available information. Guidelines for prospective parents that could reduce the likelihood that their child will have a major cardiac malformation are given. Issues related to pregnancy monitoring are discussed. Knowledge gaps and future sources of new information on risk factors are described.

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Authors: Jenkins, K. J., Correa, A., Feinstein, J. A., Botto, L., Britt, A. E., Daniels, S. R., Elixson, M., Warnes, C. A., & Webb, C. L.
Affiliations: Boston Children's Hospital (US)
ORCID: Jenkins, Kathy J.
Correa, Adolfo
Feinstein, Jeffrey A.
Botto, Lorenzo
Daniels, Stephen R.
Warnes, Carole A.
Webb, Catherine L.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2007-06-12
Volume: 115
Issue: 23
Pages: 2995-3014
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.106.183216
OpenAlex: W2617245041
Cited by: 818
References: 232
Citations by year: 2026: 21 · 2025: 26 · 2024: 50 · 2023: 42 · 2022: 52 · 2021: 42 · 2020: 50 · 2019: 48 · 2018: 52 · 2017: 38 · 2016: 43 · 2015: 61 · 2014: 55 · 2013: 52 · 2012: 48
FWCI: 3.84
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords: congenital heart disease, modifiable risk factors, fetal heart development, periconceptional folic acid supplementation, maternal rubella infection, phenylketonuria, pregestational diabetes, thalidomide, retinoids, prenatal drug exposure, environmental exposure, paternal exposure, pregnancy monitoring
MeSH terms: Female, Fetal Diseases, Heart Defects, Congenital, Humans, Pregnancy, Risk Factors, Cardiovascular Abnormalities, Maternal Exposure, Dietary Supplements

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Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young: Endorsed by the American Academy of Pediatrics

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