Women who give birth to infants with congenital heart defects (CHD) have a greater risk of developing cardiovascular disease (CVD) later in life than women whose babies do not have CHD, a Canadian study found.
The study, published in Circulation, reviewed data on more than a million women who gave birth in Quebec from 1989 to 2013.
“We examined outcomes graded on the assessment of CHD severity in the offspring,” says Brian J. Potter, MDCM, SM, FRCPC, interventional cardiologist at the Centre Hospitalier de l’Université de Montréal (CHUM) and Investigator at the Centre de Recherche du CHUM. “The risk of later cardiovascular hospitalization increased by 43 percent in women who had offspring with severe CHD and by 24 percent in women whose infants had milder forms of CHD.”
Severe CHD in infants were also linked to a 2.61-fold increase in risk for heart attack, 3.04-fold increase in risk for other atherosclerotic disease and 43.2-fold increase in risk for cardiac transplant.
Building on Earlier Research
The study is one of many that have examined the link between infants’ health at birth and their mothers’ subsequent long-term risks for disease and mortality. These include a study published in 2011, also in Circulation, finding that mothers who gave birth to preterm infants or infants with low birth weight were more likely to face hospitalization or death from CVD later in life.
More recently, a study in JAMA Network Open found that women who gave birth to infants with major congenital anomalies faced a 15–37 percent higher risk of premature cardiovascular disease — findings that echo Dr. Potter’s results.
“We looked at a broad range [of congenital anomalies], but our findings are very similar,” says one of the authors of the JAMA Network Open article, Eyal Cohen, MD, MSc, FRCP(C), Professor of Pediatrics and Health Policy, Management and Evaluation at the University of Toronto; Associate Scientist and Interim Program Head, Child Health Evaluative Sciences; and staff physician in the Division of Pediatric Medicine at the Peter Gilgan Centre for Research and Learning at The Hospital for Sick Children. “Anytime you can replicate findings in more than one place, that’s a strong indicator that there may be truth in the findings.”
The mechanisms behind mothers’ increased risk of CVD after giving birth to a child with CHD have yet to be determined. It is possible that genetics or the added stress of raising a child with a congenital condition may play a role, Dr. Potter’s and Dr. Cohen’s studies hypothesize.
“We know that women are underdiagnosed and undertreated for heart disease,” Dr. Potter says. “If we can identify additional factors for predisposition to heart disease, it may prompt physicians to be more aggressive with preventive therapies for women.”