Maternal Viral Infection and Risk of Fetal Congenital Heart Diseases: A Meta-Analysis of Observational Studies.

Authors:
Ziwei Ye
Ziwei Ye
School of Environmental Science and Engineering
Knoxville | United States
Lesan Wang
Lesan Wang
Xiangya School of Public Health
Tubao Yang
Tubao Yang
Central South University
China
LiZhang Chen
LiZhang Chen
Central South University
China
Tingting Wang
Tingting Wang
West China Hospital
China
Letao Chen
Letao Chen
Xiangya School of Public Health
New Haven | United States
Lijuan Zhao
Lijuan Zhao
College of Fisheries
Seattle | United States
Senmao Zhang
Senmao Zhang
Xiangya School of Public Health

J Am Heart Assoc 2019 May;8(9):e011264

1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Hunan China.

Background At present, the association between maternal viral infection and risk of congenital heart diseases ( CHD ) in offspring is uncertain; additionally, a complete overview is missing. A meta-analysis of observational studies was performed to address the question of whether women who had a history of viral infection in early pregnancy were at an increased risk of CHD in offspring, compared with mothers without viral infection. Methods and Results Unrestricted searches were conducted, with an end date parameter of July 15, 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met prestated inclusion criteria. Seventeen case-control studies involving 67 233 women were included for analysis. Both fixed-effects models (odds ratio [OR], 1.83; 95% CI , 1.58-2.12; P<0.0001) and random-effects models ( OR , 2.28; 95% CI , 1.54-3.36; P<0.0001) suggested that mothers who had a history of viral infection in early pregnancy experienced a significantly increased risk of developing CHD in offspring. For specific viral infections, the risk of developing CHD in offspring was significantly increased among mothers with rubella virus (OR, 3.49, 95% CI, 2.39-5.11 in fixed-effects models; and OR, 3.54; 95% CI, 1.75-7.15 in random-effects models) and cytomegalovirus (OR, 3.95; 95% CI, 1.87-8.36 in fixed-effects models) in early pregnancy; however, other maternal viral infections in early pregnancy were not significantly associated with risk of CHD in offspring. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed. Conclusions Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests that maternal viral infection is significantly associated with risk of CHD in offspring.

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Source
https://www.ahajournals.org/doi/10.1161/JAHA.118.011264
Publisher Site
http://dx.doi.org/10.1161/JAHA.118.011264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512143PMC
May 2019
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