Maternal reproductive history and the risk of isolated congenital malformations

Abstract

We examined the relationship between maternal reproductive history and the newborn's risk of isolated congenital malformations in a large case-control cohort from the Polish Registry of Congenital Malformations. Congenital malformations were classified into four categories: isolated congenital heart defects (n=1673), isolated cleft palate (n=255), cleft lip with or without cleft palate (n=448) and renal agenesis (n=103). The case groups were compared with a shared group of 2068 controls recruited in the same time period and geographic area. Multivariable logistic regression was used to assess the risk associated with maternal gravidity and of previous miscarriages after accounting for maternal age and other potential risk factors. In unadjusted analyses, maternal gravidity was significantly associated with increased risk of all four classes of congenital malformations. After adjustment, a significant association persisted for congenital heart defects [odds ratio (OR)=1.22, [95% confidence interval (CI) 1.09, 1.36], P=0.0007] and cleft lip with or without cleft palate (OR=1.21, [95% CI 1.09, 1.36], P=0.0005). A similar trend existed for isolated cleft palate (OR=1.18, [95% CI 1.02, 1.37], P=0.03). There was no appreciable increase in the risk of congenital malformations associated with a maternal history of miscarriages, but a trend for a protective effect on the occurrence of cleft lip with or without cleft palate was observed (OR=0.72, [95% CI 0.52, 0.99], P=0.045). Based on our data, maternal gravidity represents a significant risk factor for congenital heart defects and cleft lip with or without cleft palate in the newborn infant. Our data do not support an increase in risk because of past history of miscarriages.

Maternal Socioeconomic Status and the Risk of Congenital Heart Defects in Offspring: A Meta-Analysis of 33 Studies

“…All of the studies were published from 1989 to 2013. There were 31 case–control studies [15] , [20] – [37] , [39] – [41] , [43] – [48] , [52] – [54] and 2 cohort studies [38] , [42] . The main characteristics of the included studies are shown in Table 1.…”

“…The main characteristics of the included studies are shown in Table 1. In all, 20 studies [16] , [23] – [25] , [27] – [33] , [35] , [38] , [39] , [42] – [44] , [46] , [52] , [54] were conducted in the United States/Canada, 11 in Europe [20] – [22] , [34] , [36] , [37] , [40] , [41] , [45] , [47] , [53] , and 2 in other regions (1 in China and 1 in Egypt) [26] , [35] ; 29 studies were conducted in high-income countries and 4 in middle or low-income countries. Of the studies examined, 29 investigated the association of educational attainment with CHD risk [16] , [20] , [21] , [23] – [45] , [47] , [52] , [53] , 6 examined the association of family income level with CHD risk [23] , [24] , [29] , [31] , [39] , [54] , and 5 examined the association of occupational categories with CHD risk [22] , [34] , [44] , [46] , [48] .…”

Maternal and fetal safety of intravenous immunoglobulin in women with reproductive failure

“…Meanwhile, the prevailing opinion in patients with a maternal history of RPL, which consisted of the other two-thirds of our study group, is that the RPL itself is a risk factor for birth defects of next pregnancies. 20 The transfer of IgG from mother to fetus begins from 12 weeks of GA. 18 The amount of transferred IgG increases with gestational age and sharply increases from late second trimester (28-32 weeks of GA). Finally at term, fetal IgG level exceeds the maternal one.…”

Inclusion of Body Mass Index in the History of Present Illness

“…Table 1 describes the most frequent adverse obstetric outcomes or conditions and their association with the various descriptors, including maternal age, gravidity, parity, history of preterm delivery, history of abortions, race and ethnicity, and prepregnancy BMI. Of the 34 listed adverse obstetric outcomes or conditions, maternal age was linked to 20 (59%), [3][4][5][6][7][8][9][10][11][12][13][14][15] gravidity was linked to 11 (32%), 10,12,13,[16][17][18][19][20][21] parity was linked to 14 (41%), [10][11][12]14,18,19,22 history of preterm birth was linked to 18 (53%), 9,20,22,23 history of abortions was linked to 8 (24%), 17,19-21 and race and ethnicity were linked to 17 (50%). 15,[23][24][25][26][27] As shown in Table 3, BMI had the strongest association (32 [94%]) with adverse pregnancy outcomes or conditions.…”