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Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis

Chayamon Suwansumrit
Chayamon Suwansumrit
 e 
Worawan Jittham
Worawan Jittham
   | 30 dic 2021
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INFORMAZIONI SU QUESTO ARTICOLO
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Article Category: Original article
Pubblicato online: 30 dic 2021
Pagine: 267 - 276
DOI: https://doi.org/10.2478/abm-2021-0033
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© 2021 Chayamon Suwansumrit et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Participant flow diagram of CHD cases and patient controls. CHD, congenital heart diseases; PDA, patent ductus arteriosus.
Participant flow diagram of CHD cases and patient controls. CHD, congenital heart diseases; PDA, patent ductus arteriosus.

Demographic data for cases of CHD and unaffected control patients.

Characteristic Case (n = 249)n (%) Control (n = 304)n (%) P
Sex† 0.033
  Male 124 (49.8) 179 (58.9)
  Female 125 (50.2) 125 (41.1)
Age† (years) <0.001
  <1 50 (20.1) 71 (23.4)
  1–5 86 (34.5) 165 (54.2)
  6–10 63 (25.3) 47 (15.5)
  >10 50 (20.1) 21 (6.9)
Gravida 0.29
  Primigravida 112 (45.0) 123 (40.5)
  Multigravida 137 (55.0) 181 (59.5)
Parity 0.67
  1 118 (47.4) 140 (46.0)
  2 101 (40.6) 133 (43.8)
  3 or more 30 (12.0) 31 (10.2)
History of abortion‡ 0.050
  None 220 (88.4) 252 (82.9)
  1 27 (10.8) 41 (13.5)
  2 or more 2 (0.8) 11 (3.6)
Gestational weeks‡ 0.02
  <34 0 (0) 8 (2.6)
  34–36 26 (10.4) 36 (11.8)
  ≥ 37 223 (89.6) 260 (85.5)

Parental risk factors for CHDs on multiple logistic regression.

Factor Case (n = 249)n (%) Control (n = 304)n (%) AOR 95% CI P
Family history of congenital heart disease 0.005*
  Yes 21 (8.4) 6 (2.0) 4.67 1.61–13.57
  No 228 (91.6) 298 (98.0) 1.00 Ref.
Maternal exposure to second-hand smoke 0.002*
  Yes 151 (60.6) 121 (39.8) 1.58 1.03–2.42
  No 98 (39.4) 183 (60.2) 1.00 Ref.
GDM
  Yes 11 (4.4) 31 (10.2) 0.60 0.27–1.33 0.21
  No 238 (95.6) 273 (89.8) 1.00 Ref.
Paternal smoking 0.12
  Yes 134 (53.8) 124 (40.8) 1.45 0.23–2.88
  No 115 (46.2) 180 (59.2) 1.00 Ref.
Paternal alcohol drinking 0.16
  Yes 176 (70.7) 189 (62.2) 1.38 0.88–2.16
  No 73 (29.3) 115 (37.8) 1.00 Ref.
History of pesticide exposure 0.11
  Yes 57 (22.9) 23 (7.6) 1.88 0.87–4.05
  No 192 (77.1) 281 (92.4) 1.00 Ref.
Occupation 0.64
  Farmer 38 (15.3) 9 (3.0) 0.68 0.14–3.32
  Manual worker 33 (13.3) 11 (3.6) 1.32 0.32–5.50
  Merchant/Self-employed 30 (12.0) 42 (13.8) 0.32 0.09–1.22
  Employee 74 (29.7) 80 (26.3) 0.43 0.18–1.56
  Government officer 22 (8.8) 90 (29.7) 0.16 0.04–0.64
  Housekeeper 43 (17.3) 67 (22.0) 0.24 0.07–0.89
  Student 9 (3.6) 5 (1.6) 1.00 Ref.
Maternal educational attainment 0.50
  Primary school or lower 52 (20.9) 27 (8.9) 1.00 Ref.
  Junior high school 56 (22.5) 37 (12.2) 1.58 0.71–3.56
  High school 87 (34.9) 92 (30.3) 1.59 0.78–3.26
  Bachelor degree or higher 54 (21.7) 148 (48.6) 1.13 0.63–2.03
Family income per month baht (USD)† 0.53
  <10,000 (323) 55 (22.1) 44 (14.5) 1.00 Ref.
  10,000–30,000 (323–996) USD) 152 (61.1) 138 (45.4) 1.08 0.43–2.70
  30,001–50,000 (996–1610) 25 (10.0) 76 (25.0) 1.40 0.65–3.00
  >50,000 baht (>1610) 17 (6.8) 46 (15.1) 0.96 0.43–2.12

Parental socioeconomic status univariate analysis.

Characteristic Case (n = 249)n (%) Control (n = 304)n (%) OR 95% CI P
Occupation <0.001*
  Farmer 38 (15.3) 9 (3.0) 2.35 0.63–8.72
  Manual worker 33 (13.3) 11 (3.6) 1.67 0.46–6.05
  Merchant/self-employed 30 (12.0) 42 (13.8) 0.40 0.12–1.30
  Employee 74 (29.7) 80 (26.3) 0.51 0.17–1.60
  Government officer 22 (8.8) 90 (29.7) 0.14 0.04–0.45
  Housekeeper 43 (17.3) 67 (22.0) 0.36 0.114–1.14
  Student 9 (3.6) 5 (1.6) 1.00 Ref.
Maternal educational attainment <0.001*
  Primary school or lower 52 (20.9) 27 (8.9) 1.00 Ref.
  Junior high school 56 (22.5) 37 (12.2) 0.79 0.42–1.47
  High school 87 (34.9) 92 (30.3) 0.49 0.28–0.85
  Bachelor degree or higher 54 (21.7) 148 (48.6) 0.19 0.11–0.33
Family income per month baht (USD)† <0.001*
  <10,000 (<322) 55 (22.1) 44 (14.5) 1.00 Ref.
  10,000–30,000 (322–966) 152 (61.1) 138 (45.4) 0.88 0.56–1.39
  30,001–50,000 (966–1611) 25 (10.0) 76 (25.0) 0.26 0.14–0.48
  >50,000 (>1611) 17 (6.8) 46 (15.1) 0.30 0.15–0.59

Familial biological data as a risk of CHDs on univariate analysis.

Characteristic Case (n = 249)n (%) Control (n = 304)n (%) OR 95% CI P
Family history of congenital heart disease 0.001*
  Yes 21 (8.4) 6 (2.0) 4.58 1.82–11.52
  No 228 (91.6) 298 (98.0) 1.00 Ref.
Maternal age (years) 0.67
  <20 26 (10.4) 27 (8.9) 1.00 Ref.
  20–35 183 (73.5) 221 (72.7) 0.86 0.49–1.53
  ≥ 35 40 (16.1) 56 (18.4) 0.74 0.38–1.46
Paternal age (years) 0.84
  <20 11 (4.4) 16 (5.3) 1.00 Ref.
  20–35 164 (65.9) 194 (63.8) 1.23 0.56–2.72
  ≥ 35 74 (29.7) 94 (30.9) 1.15 0.50–2.62
Maternal pregnancy complication
GDM 0.013*
  Yes 11 (4.4) 31 (10.2) 0.41 0.20–0.83
  No 238 (95.6) 273 (89.8) 1.00 Ref.
Pregnancy-induced hypertension 0.11
  Yes 8 (3.2) 19 (6.3) 0.50 0.21–1.16
  No 241 (96.8) 285 (93.7) 1.00 Ref.

Parental environmental hazard exposure on univariate analysis.

Characteristics Case (n = 249)n (%) Control (n = 304)n (%) OR 95% CI P
Maternal smoking 0.11
  Yes 6 (2.4) 2 (0.7) 3.73 0.75–18.64
  No 243 (97.6) 302 (99.3) 1.00 Ref.
Maternal exposure to second-hand smoke <0.001*
  Yes 151 (60.6) 121 (39.8) 2.33 1.65–3.28
  No 98 (39.4) 183 (60.2) 1.00 Ref.
Paternal smoking 0.002*
  Yes 134 (53.8) 124 (40.8) 1.69 1.21–2.37
  No 115 (46.2) 180 (59.2) 1.00 Ref.
Maternal alcohol drinking 0.98
  Yes 16 (6.5) 20 (6.6) 0.98 0.50–1.93
  No 232 (93.5) 284 (93.4) 1.00 Ref.
Paternal alcohol drinking 0.036*
  Yes 176 (70.7) 189 (62.2) 1.47 1.03–2.10
  No 73 (29.3) 115 (37.8) 1.00 Ref.
History of pesticide exposure <0.001*
  Yes 57 (22.9) 23 (7.6) 3.63 2.16–6.09
  No 192 (77.1) 281 (92.4) 1.00 Ref.
History of chemical exposure 0.53
  Yes 5 (2.0) 4 (1.3) 1.54 0.41–5.79
  No 244 (98.0) 300 (98.7) 1.00 Ref.
History of paint exposure 0.38
  Yes 12 (4.8) 20 (6.6) 0.72 0.34–1.50
  No 237 (95.2) 284 (93.4) 1.00 Ref.

Diagnosis of congenital heart disease.

Diagnosis n = 249 (%)
Less severe 155 (62.2)
  VSD 69 (27.7)
  ASD 41 (16.5)
  PDA 22 (8.8)
  Pulmonary stenosis 20 (8.0)
  Aortic stenosis 1 (0.4)
  Aortic regurgitation 1 (0.4)
  Coarctation of aorta 1 (0.4)
Severe 94 (37.8)
  TOF 35 (14.0)
  Double outlet of right ventricle 13 (5.2)
  Single ventricle 11 (4.4)
  Pulmonary atresia with VSD 8 (3.2)
  Ebstein anomaly 7 (2.8)
  Transposition of the great vessels 7 (2.8)
  Pulmonary atresia with intact ventricular septum 4 (1.6)
  Atrioventricular canal defect 4 (1.6)
  Tricuspid atresia 3 (1.2)
  Anomalous left coronary artery from the pulmonary artery 1 (0.4)
TAPVR 1 (0.4)
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