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Potential risk factors for Ebstein anomaly, National Birth Defects Prevention Study, 1997–2011

Published online by Cambridge University Press:  04 June 2019

Karrie F. Downing Open the ORCID record for Karrie F. Downing [Opens in a new window] ,
Tiffany Riehle-Colarusso ,
Suzanne M. Gilboa ,
Angela E. Lin ,
Matthew E. Oster ,
Sarah C. Tinker ,
Sherry L. Farr  and
the National Birth Defects Prevention Study
Karrie F. Downing*
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
Tiffany Riehle-Colarusso
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Suzanne M. Gilboa
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Angela E. Lin
Affiliation:
Medical Genetics Unit, MassGeneral Hospital for Children, Boston, MA, USA
Matthew E. Oster
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
Sarah C. Tinker
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Sherry L. Farr
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
the National Birth Defects Prevention Study
Affiliation:
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA Medical Genetics Unit, MassGeneral Hospital for Children, Boston, MA, USA Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
*
Author for correspondence: Karrie F. Downing, MPH, 4770 Buford Hwy, Mailstop S106-3, Atlanta, GA 30341, USA. Tel: +1 404 498 0710; Fax: +1 404 498 3040; Email: [email protected]
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Abstract

Background:

Ebstein anomaly is a rare congenital heart defect (CHD) that, when severe, requires corrective surgery or other catheter-based intervention in the first year of life. Due to its rarity, risk factors for Ebstein anomaly remain largely unknown. Using national data, we examined 18 potential risk factors for Ebstein anomaly.

Methods:

Using 1997–2011 data from the National Birth Defects Prevention Study, a population-based case–control study, we calculated crude and adjusted odds ratios and 95% confidence intervals for paternal age, maternal socio-demographics, reproductive history, and modifiable risk factors, and infant characteristics reported by mothers of 135 Ebstein anomaly cases and 11,829 controls.

Results:

Mothers of Ebstein anomaly cases had 4.1 (95% confidence interval: 1.8, 9.5) times the odds of reporting a family history of CHD compared with mothers of controls. Ebstein anomaly was associated with maternal second-hand cigarette smoke exposure at home (odds ratio = 2.2 [95% confidence interval: 1.1, 4.4]), but not maternal cigarette smoking (odds ratio = 1.3 [95% confidence interval: 0.8, 2.1]). Odds were elevated, but the 95% confidence interval included 1.0, for maternal marijuana use (odds ratio = 1.8 [95% confidence interval: 0.9, 3.8]) and paternal age ≥40 years at delivery (odds ratio = 1.9 [95% confidence interval: 1.0, 3.5]).

Conclusions:

Maternal exposure to second-hand cigarette smoke at home and a family history of CHD were associated with elevated odds of Ebstein anomaly. Genetic analyses could clarify the potential heritability of Ebstein anomaly.

Keywords

Ebstein anomalycongenital heart defectrisk factorscase–control studyprenatal exposure
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 6 , June 2019 , pp. 819 - 827
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Copyright
© Cambridge University Press 2019 

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