Maternal Viral Infection and Risk of Fetal Congenital Heart Diseases: A Meta‐Analysis of Observational Studies

Journal Article 2 Mentions

Zi‐Wei Ye•2019

Lesan WangTubao Yang

Top 4% · 96th Percentile

69 citations · Epidemiology

Open Access

TLDR

Women who had a viral infection early in pregnancy were more likely to have a child with a heart defect, especially after two particular infections. The results show a link, but they do not prove that infection caused the defects.

Summary

AI Generated

This content was automatically synthesized by Credo's AI models directly from the original source text.

AI summaries can make mistakes — double-check important details against the original source.

1 Study Aim

The authors aimed to determine whether viral infections during early pregnancy are linked to congenital heart disease (CHD; a structural heart problem present at birth) in children. They also examined whether the association differed by virus type. The study asked whether infections early in pregnancy are connected with heart problems in babies.

2 Study Design

The researchers combined results from 17 case-control studies (studies comparing people with an outcome to similar people without it), covering 67,233 women. They searched medical and Chinese-language databases through July 15, 2018. All studies examined infections during the first trimester, and all assessed congenital heart disease using ultrasound or surgery. Nine studies used laboratory tests to identify infection; the others used questionnaires. Six studies adjusted for other factors that might affect the association. The authors used two statistical models and checked whether results changed when studies were excluded. The researchers brought together earlier comparisons of women with and without infected pregnancies.

3 Findings

Across all viruses, the estimated odds of CHD were higher after maternal infection: odds ratio (OR; a comparison of the odds between groups) 1.83 in one model and 2.28 in another. The results varied substantially across studies. Rubella infection was associated with higher odds in both models; cytomegalovirus (CMV; a specific virus) was associated with higher odds in the fixed-effects model, but not the random-effects model. Other virus types showed no significant association. Results remained similar in sensitivity checks, and statistical tests found no clear publication bias, though the authors cautioned that bias and differences among studies could affect conclusions. They called for large, multicenter prospective studies. Early pregnancy infections, especially rubella, may be linked to heart problems in babies, but more research is needed.

Abstract

Background At present, the association between maternal viral infection and risk of congenital heart diseases ( CHD ) in offspring is uncertain; additionally, a complete overview is missing. A meta-analysis of observational studies was performed to address the question of whether women who had a history of viral infection in early pregnancy were at an increased risk of CHD in offspring, compared with mothers without viral infection. Methods and Results Unrestricted searches were conducted, with an end date parameter of July 15, 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met prestated inclusion criteria. Seventeen case-control studies involving 67 233 women were included for analysis. Both fixed-effects models (odds ratio [OR], 1.83; 95% CI , 1.58-2.12; P<0.0001) and random-effects models ( OR , 2.28; 95% CI , 1.54-3.36; P<0.0001) suggested that mothers who had a history of viral infection in early pregnancy experienced a significantly increased risk of developing CHD in offspring. For specific viral infections, the risk of developing CHD in offspring was significantly increased among mothers with rubella virus (OR, 3.49, 95% CI, 2.39-5.11 in fixed-effects models; and OR, 3.54; 95% CI, 1.75-7.15 in random-effects models) and cytomegalovirus (OR, 3.95; 95% CI, 1.87-8.36 in fixed-effects models) in early pregnancy; however, other maternal viral infections in early pregnancy were not significantly associated with risk of CHD in offspring. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed. Conclusions Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests that maternal viral infection is significantly associated with risk of CHD in offspring.

Primary Link Archive Pubmed DOI Openalex Full text (OA)