Future parents' lifestyle choices affect babies' risk of heart defects
May 22, 2007
Kathy Jenkins, MD, MPHProspective parents can take positive lifestyle steps to increase the chance that their babies will be born with a healthy heart, according to a new American Heart Association scientific statement.
The "Non-inherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge" statement is published in Circulation: Journal of the American Heart Association.
"Lifestyle choices that prospective mothers make may reduce the risk of giving birth to a baby with heart defects," said Kathy Jenkins, MD, MPH, lead writer of the non-inherited risks statement and senior associate in Cardiology at Children's Hospital Boston.
"This statement highlights the need to think about prevention of heart defects in babies before conception and very early in pregnancy," said Catherine Webb, MD, MS, senior author of the statement, pediatric cardiologist at Children's Memorial Hospital in Chicago and professor of pediatrics at Northwestern University Feinberg School of Medicine. "Paying attention to parental lifestyle issues and the association with congenital heart disease is a good start. However, congenital heart disease may still occur in children despite excellent prenatal care and the very best efforts on the parents' part. It is very important to continue to learn much more about prevention of congenital heart disease through ongoing research studies."
The American Heart Association's Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young examined the latest knowledge reflected in medical/scientific literature, which shed light on modifiable risk factors for congenital heart defects.
"This is a new way of thinking and a positive vision of how prospective mothers can influence and protect a child from being born with a heart defect," Jenkins said.
The committee had four key recommendations based on the literature review. These lifestyle recommendations range from three months before pregnancy through the first trimester of pregnancy.
The first and most important recommendation is to talk to your doctor. Good preconception and prenatal care is important to the birth of a heart-healthy baby.
Prospective mothers should be checked for diabetes, rubella (German or three-day measles) and influenza. Women of child-bearing age need to be immunized against rubella. Otherwise, rubella infection early in gestation carries the risk of congenital rubella syndrome in offspring. Diabetes needs to be diagnosed and controlled.
"A second recommendation is for women to take a daily multivitamin containing 400 micrograms (mcg) of folic acid or a folic acid supplement," said Jenkins, who is also associate professor of pediatrics at Harvard Medical School in Boston, Mass.
Folic acid is critical to the normal growth and development of the fetus and appears to have a protective effect against the development of heart defects. Data suggest intake of folic acid is particularly important prior to conception.
Third, parents should review medication use -- even over-the-counter medications -- with their doctor.
The last recommendation centers on what the prospective mother should avoid, such as contact with people who have the flu or other fever-related illnesses. Any fever-related illness during the first trimester of pregnancy may carry a two-fold higher risk of offspring with heart defects.
Congenital heart defects, both simple and severe, are structural problems with the heart present at birth. They result when a mishap occurs during heart development soon after conception and often before the woman is aware she is pregnant. The American Heart Association estimates that out of 1,000 births, nine babies will have some form of congenital heart disorder. Congential cardiovascular defects are the most common birth defects.
In the future, two major national studies -- the National Birth Defect Prevention Study and National Children's Study -- are expected to further illuminate additional factors that may help reduce heart defects.
Children's Hospital Boston is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine and 10 members of the Howard Hughes Medical Institute comprise Children's research community. Founded as a 20-bed hospital for children, Children's Hospital Boston today is a 347-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children's also is the primary pediatric teaching affiliate of Harvard Medical School. For more information about the hospital and its research visit: www.childrenshospital.org/newsroom.