Risk factors for the development of congenital heart defects in Kyrgyz Republic

Objective: Congenital heart diseases (CHD) are structural abnormalities of the heart and/or great vessels that are present at birth. CHD is still the most common inborn defect with an approximate prevalence of 5–11 per 1000 live births and incidence of 1%. CHDs are caused by many factors, often a mix of genetic predispositions and environmental influences, though the specific cause is unknown for most cases. The aim was to study the risk factors for congenital heart defects, to identify risk groups in whom CHD may occur. Methods: We conducted a survey of parents of children with CHD (the main group, n=392) and parents of healthy children (the control group, n=100), followed by an analysis of the clinical, anamnestic, and medical-social characteristics of parents of children in both groups. The following groups of risk factors were identified: demographic factors, socio-hygienic factors, biological factors, and chemical factors. Results: The most important risk factors for the development of CHD in children were bad habits of parents: maternal smoking and alcoholism ((4.1 (0.2) vs. 1.0 (0.2), p<0.001, main group vs control; (1.5 (0.1) vs. 0.0, p<0.001, respectively), paternal smoking (57.1 (1.6) vs. 39.0 (5.9), p<0.01), paternal alcoholism (28.6 (0.3) vs. 2.0 (0.5) p<0.001); infectious and inflammatory diseases of the mother during pregnancy: acute respiratory viral infections (40.8 (1.5) vs. 12.0 (2.6); p<0.001, main vs. control group), intrauterine infections (20.1 (1.0) vs. 1.0 (0.2), p<0.001); as well as the associated use of antibacterial drugs. Conditions directly related to pregnancy (severe toxicosis, maternal age, gestosis of pregnant women, anemia) made a less noticeable but significant contribution to determining the risk. The increased risk of having a child with CHD was determined by a number of socio-economic factors: marital status, low-income families (28.8 (1.3) vs 7.0 (1.6) main vs control group, p<0.001) and low educational level of the mothers of patients (9.4 (0.5) vs. 7.0 (1.6), p<0.001). Conclusion: Thus, the most important risk factors for the development of CHD in children were smoking and alcoholism of parents, infectious and inflammatory diseases of the mother during pregnancy, as well as the associated use of antibacterial drugs; pregnancy-related factors as severe toxicosis, maternal age, gestosis of pregnant women, anemia; and socio-economic factors as marital status, low-income families, low educational level of the mothers of patients. The influence of these factors on the risk of CHD is indirect and largely depends on the quality of medical supervision of patients from socially disadvantaged families during pregnancy, since, as the study shows, such patients are registered late and follow medical recommendations less often.