Congenital Heart Disease
Conditions
Keywords
Congenital Heart Disease, Key Nutritional Factors, conception, pregnant
Brief summary
The study is a nested case-control study and the purpose is to describe the status of key nutrients(eg.folic acid and vitamins) supplementation among pregnant women in Shanghai, to find out the association between the level of serum key nutrients during peri-conceptional period and the incidence of congenital heart defects (CHD) in newborn, and to provide better preconception care.
Detailed description
Congenital heart defects (CHD) are among the most common major congenital anomalies with an incidence of about 8-12/1,000 live births worldwide. The mechanism of CHD is still unclear. Many studies indicated that the level of key nutrients (eg.folic acid and vitamins) during peri-conceptional period might affect the incidence of CHD, but the evidence is limited. The study aimed to explore the association between serum key nutrients during peri-conceptional period and the incidence of CHD in newborn. All couples attending pre-pregnancy physical examination from 11 districts (Minhang District, Huangpu District, Xuhui District, Changning District, Jingan District, Putuo District, Yangpu District, Jiading District, Pudong District，Songjiang District, Qingpu District) in Shanghai from March 2016, are recruited and their blood samples and questionnaires about the supplementation of key nutrients are collected. During the gestation, venous blood of pregnant women at all of three trimesters is taken. Besides, questionnaires about the supplementation of key nutrients at the first antenatal visit are also obtained. The level of serum folic acid, vitamin A and vitamin B12 at preconception and during gestation are measured. Finally, investigators identifies those whose newborns developed CHD during follow-up as the cases. Then, investigators selects four controls for each case from the rest of the cohort by matching on constitutional determinants of CHD such as age and sex. Participants are identified by national identification number during the follow up. The level of serum key nutrients is compared in cases and controls. Univariate and multivariate association analyses will be performed to identify risk factors to CHD by using multivariate logistic regression model.
Interventions
OTHERobservation
This is an observational study
Sponsors
Children's Hospital of Fudan University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* attend pre-pregnancy physical examination from 11 districts in Shanghai, OR pregnant women present at first antenatal care \< 14 week of gestation * plan to deliver in Shanghai
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| preconceptional maternal serum folate level | usually 6 months before pregnancy | a serum sample collected at preconception and/or early conception will be used for examination |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The status of serum Vitamin D level | periconception period ( defined as around 6 months before and the first 3 months of gestation | a serum sample collected at preconception and/or first antenatal visit will be used for examination |
| Pre-conceptional maternal diet folic acid supplement intake | preconception examination (usually 0-6 months before pregnancy) | a questionnaire administered at preconception and early conception will be used for estimation based on the dose and frequency of supplements intake |
| early conceptional maternal serum folate deficiency | first antenatal visit (usually 12th-16th gestational week) | a serum sample collected at early conception will be used for examination |
| neonatal congenital heart disease(CHD) status | Congenital heart disease screening during 6-72 hours after delivery | The newborn babies with heart murmurs(≥ 2 grade) and subnormal Pulse Oximetry reading positive will be considered positive-screened and echocardiography will performed. |
| Peri-conceptional paternal serum folate level | usually between 0-6 months before and 3 months after conception) | a serum sample collected at preconception and/or early conception will be used for examination |
| Peri-conceptional maternal plasma homocysteine level | peri-conception examination ( defined as about 6 months before and 3 months after conception | a plasma sample collected at preconception and first antenatal visit will be used for examination |
Countries
China
Outcome results
None listed