TLDR
Illnesses during the first months of pregnancy were linked to a higher chance of heart defects in babies. The link differed by infection and defect, and more research is needed to confirm which illnesses matter most.
Summary
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1 Study Aim
The authors aimed to combine current evidence on whether infections during the first trimester (the first three months of pregnancy) are linked to congenital heart defects (structural problems of the heart present at birth). They also examined whether links differed by infection and defect type. The study asked whether early pregnancy illnesses are connected to heart problems in babies.
2 Study Design
The authors conducted a systematic review (a structured search and assessment of research) and meta-analysis (a statistical combination of study results). They searched five research databases through 30 September 2024 and included 30 studies of first-trimester infections, covering 1,732,295 pregnancies. The studies included 24 case-control, three cohort, and three cross-sectional designs. Infection status came from questionnaires in 20 studies, laboratory tests in seven, and medical records in three. Random-effects models combined results while allowing for differences between studies. The researchers combined findings from many studies involving over a million pregnancies.
3 Findings
The authors found that any first-trimester infection was associated with higher odds of a baby having a heart defect: pooled odds ratio (a measure comparing the odds between groups) 1.63, with a 95% confidence interval (a range expressing uncertainty) of 1.41–1.88. Rubella, coxsackievirus, respiratory infections, and influenza were also linked to higher odds. Any infection was associated with ventricular septal defects (a hole between the heart’s lower chambers; 1.59) and atrioventricular septal defects (a problem involving the heart’s central walls and valves; 1.55). Results varied considerably across studies, and possible publication bias reduced the estimated association to 1.32. The authors urge larger studies using laboratory tests to confirm results and investigate causes. Some early pregnancy illnesses may raise the chance of certain heart problems, but better studies are needed to check this.