A Matched Case-Control Study on the Association Between Colds, Depressive Symptoms during Pregnancy and Congenital Heart Disease in Northwestern China

Abstract

The purpose of this study was to explore the association between colds, depressive symptoms during pregnancy and offspring congenital heart disease (CHD). A 1:2 matching case-control study was conducted in Northwest China. Information was gathered by a structured questionnaire and was reviewed by investigators on the spot. Multivariate logistic regressions and nonlinear mixed effect model were performed. 614 cases and 1228 controls were available in this study. After adjusting for potential confounders, the colds during the entire pregnancy were associated with increased risk of offspring CHD (OR = 1.44(1.12–1.85)). Similarly, there was a higher depression score in CHD group than the control group (OR = 1.89(1.48–2.41)). In addition, the women with both colds and higher depression scores had a higher risk of offspring CHD (OR = 2.72(1.87–3.93)) than their counterparts with only colds (OR = 1.48(1.04–2.09)) or with only higher depression scores (OR = 1.94(1.37–2.74)). The combined effects were significant in the multiplication model (OR = 2.04(1.47–2.83)) but not in the additive model (S = 1.40(0.70–2.81), AP = 0.19(−0.15–0.53) and RERI = 0.55(−0.54–1.64)). In conclusion, the colds and depressive symptoms during pregnancy were found associated with increased risk of offspring CHD and we found for the first time that there existed a statistically multiplying interaction effect of colds and depression on increasing risk of offspring CHD.

Maternal fever during preconception and conception is associated with congenital heart diseases in offspring

“…exposed group is inconsistent with our interest (n = 12) Finally, we identified 16 eligible articles [ 18 – 22 , 28 – 38 ] in this meta-analysis.…”

Maternal Psychological Distress, Education, Household Income, and Congenital Heart Defects: A Prospective Cohort Study from The Japan Environment and Children’s Study Running Title Maternal Psychological Distress and Congenital Heart Defects

“…A Chinese case-control study found that prenatal depressive symptoms had signi cantly increased OR (1.94) for CHD. However, the symptoms were evaluated using the Zung Self-Rating Depression Scale after birth, leading to recall bias [12]. Meanwhile, in the UK cohort, diagnosis of depression without antidepressant use during the rst trimester had no signi cant OR (1.10).…”

“…A lower socioeconomic status is associated with common mental disorders [9,10], and the association between anti-depressant use during pregnancy and CHD has been reported in a meta-analysis [11]. Concerning actual depressive symptoms, a case-control study in China reported that depressive symptoms during pregnancy were related to a signi cantly increased odds ratio (OR) for infant CHDs [12]. However, the diagnosis of depression in a UK cohort and depressive symptoms in a Northern Ireland case-control study was not related to infant CHDs [8,13].Thus, whether maternal psychological distress, including depressive symptoms, is a risk factor for CHD has not been fully investigated, and there have been no reports on the combined effects of maternal education, income, and maternal psychological distress on CHD.…”

Geographical variations in maternal lifestyles during pregnancy associated with congenital heart defects among live births in Shaanxi province, Northwestern China

“…Therefore, we hypothesized that the relationship between maternal lifestyle during pregnancy and CHD varied significantly from region to region in Shaanxi. In most previous studies, however, conventional regression models were used to produce average parameters to explore the relationship between maternal lifestyle during pregnancy and CHD over the whole study area, but spatial heterogeneity was neglected 17 – 20 . In the present study, we used the Geographically Weighted Logistic Regression (GWLR) model to generate local coefficients to account for geographical variations in evaluating the correlation between CHD in infants and maternal lifestyles during pregnancy.…”

“…Other socio-demographic factors included fetal gender (male, female), fetal number (singleton, twin and multi-fetal), infant parity (1, 2, or ≥ 3), childbearing age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), ≥ 30 years), mother's education (primary school and below, junior high school, senior high school, college and above), mother's marriage (first marriage, others), household registration (urban, rural), Household wealth Index (poor, middle-income, rich), altitude of residence (< 500, 500-1000, > 1000), mother's residence during pregnancy (floating, permanent), family history of CHD (no , yes), and area (South Shaanxi, Central Shaanxi, North Shaanxi). Household wealth index based on the principal component analysis was used to assess the household economic level of the participants.…”