Birth outcomes of cases with isolated atrial septal defect type II--a population-based case-control study.

OBJECTIVES

In general, epidemiological studies have evaluated cases with congenital cardiovascular abnormalities together. The aim of this study is to describe the birth outcomes of cases with isolated/single atrial septal defect type II (ASD-II, i.e. only a fossa ovalis defect) after surgical correction or lethal outcome in the light of maternal sociodemographic data.

DESIGN

Comparison of birth outcomes and maternal characteristics of cases with ASD-II and controls without defect.

SETTING

The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities.

POPULATION

Hungarian newborn infants with or without ASD-II.

METHODS

Medically recorded birth outcomes, maternal age and birth order were evaluated. Marital and employment status was based on maternal information. The lifestyle factors were analyzed in a subsample of mothers visited at home based on a personal interview with mothers and their close relatives, and the family consensus was accepted.

MAIN OUTCOME MEASURES

Mean gestational age at delivery and birthweight, rate of preterm birth and low birthweight, maternal age, birth order, marital and employment status.

RESULTS

The evaluation of 471 cases with ASD-II and 38,151 controls without any defects showed a female excess in cases with ASD-II, having shorter gestational age and lower mean birthweight, and thus a higher rate of preterm births and low birthweight.

CONCLUSIONS

Intrauterine growth restriction and shorter gestational age were found in cases with ASD-II, particularly in female children. These factors may have a general developmental process in which there was not closure of the foramen ovale, thus echocardiographic screening of these babies might be of value.