Abstract
The possible effect of environmental factors during pregnancy on the occurrence of atrial septal defect (ASD-secundum) in the offspring was studied in 50 cases and 756 controls. The cases represented all verified ASDs in Finland during 1982–1983. The controls were randomly selected from all infants born during the same period. Case and control mothers were interviewed by midwives using a structured questionnaire approximately three months after delivery. Congenital heart disease was more prevalent among parents of cases than those of controls. Maternal alcohol consumption during the first trimester of pregnancy appeared to double the risk of atrial septal defect (OR =1.9, Cl95 =1.1- 3.4). Maternal exposure to chemicals at work during the first trimester was more prevalent among the ASD-group (40.0%) than the control group (26.2%). The risk of ASD was not associated with maternal smoking, or coffee, tea or acetosalicylic acid consumption.
Maternal exposure to video display terminals, microwave ovens, organic solvents, anesthetic gases, pesticides or wood preservatives during the first trimester of pregnancy were not associated with the risk of an atrial septal defect. It is concluded that some common physical and chemical exposures during early pregnancy should not necessarily be considered risk factors for atrial septal defect.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Armitage P. (1985): Statistical methods in medical research - Blackwell Scientific Publications - Oxford.
Boughman J.A., Berg K.A. and Astemborski J.A. (1987): Familiar risks of congenital heart defect assessed in a population-based epidemiologic study -Am. J. Med. Genet. 26: 839–849.
Bound J.P. and Logan W.F.W.E. (1977): Incidence of congenital heart disease in Blackpool 1957–1971 - Br. Heart J. 39: 445–450.
Campbell M. (1965): Causes of malformations of the heart - Br. Med. J. 2: 895–904.
Campbell M. and Polani P.E. (1961): Factors in the etiology of atrial septal defect - Br. Heart J. 23: 477–493.
Carlgren L.E. (1969): Kongenitala hjärtfel hos barn födda i Göteborg 1941–1960 - Läkartidningen 66: 4883–4888.
Clarren S.K. and Smith D. W. (1978): The fetal alcohol syndrome - N. Engl. J. Med. 298: 1063–1067.
Ferencz C., Rubin J., McCarter R.J. and Boughman J.A. (1987): Cardiac and non-cardiac malformations: Observations in a population-based study -Teratology 35: 367–378.
Heinonen O.P. (1976): Risk factors for congenital heart disease. A prospective study. Ketty S., Hook E.B., Janerich D.T., Porter I.H., eds. Birth Defects: Risks and consequences - Academic Press, New York, 221–264.
Henriksen J.B. (1974): Congenital heart defects in children born in Norway 1967–1968 - Tidsskr. Nor. Laegeforen 94: 624–627.
Kenna A.P., Smithless R.W. and Fielding D.W. (1975): Congenital heart disease in Liverpool: 1960–1969 - Q. J. Med. 44: 17–44.
Lemeshow S. and Hosmer D.W. Jr. (1984): Estimating odds ratios with categorially scaled covariates in multiple logistic regression analysis - Am. J. Epidemiol. 119: 147–151.
MacKenzie S.G. and Lippman A. (1989): An investigation of report bias in a case-control study of pregnancy outcome - Am. J. Epidemiol. 129: 65–75.
Mitchell S.C., Korones S.B. and Berendes H.W. (1971): Congenital heart disease in 56,109 births. Incidence and natural history - Circulation 43: 323–332.
Mäkinen L. (1981): Severe congenital cardiovascular malformations in infancy - Thesis. Helsinki.
Nadas A.S. and Fyler D.C.F. (1972): Pediatric Cardiology. WB Sounders Company - Third edition -Philadelphia- London - Toronto.
Nora J.J., McGill C.W. and McNamara D.G. (1970): Empiric recurrence risk in common and uncommon congenital heart lesions - Teratology 3: 325–329.
Nora J.J., Nora A.H. and Wexler P. (1971): Hereditary and environmental aspects as they affect the fetus and newborn - Clin. Obst. and Gynecol. 24: 851–861.
Randell C.L., Taylor J. and Walker D.W. (1977): Ethanol induced malformations in mice -Alcoholism 1: 219–244.
Richards M.R., Merritt K.K., Samuels H.M. and Langmann A.G. (1955): Congenital malformations of the cardiovascular system in a series of 6053 infants -Pediatrics 15: 12–28.
Sandor G.G.S., Smith D.F. and Maclead P.M. (1981): Cardiac malformations in the fetal alcohol syndrome- J. Pediatr. 98: 771–773.
Saxén L. (1983): Twenty years of study of the etiology of congenital malformations in Finland. In: Kalter H. ed. Issues and Reviews in Teratology. New York -Plenum Press Corporation 73–100.
Stoll C., Alembik Y., Roth M.P., Dott B. and De Geeter B. (1989): Risk factors in congenital heart disease -Eur. J. Epidemiol. 5: 382–391.
Tikkanen J. (1984): Smoking and alcohol consumption during pregnancy in Finland. Publications of the National Board of Health - Series Original Reports 4/1984 - Helsinki.
Tikkanen J. (1986): Risk factors for congenital heart disease - Thesis. Health services research by the National Board of Health in Finland - Helsinki.
Tikkanen J. and Heinonen O.P. (1988): Cardiovascular malformations and organic solvent exposure during pregnancy in Finland - Am. J. Ind. Med. 14: 1–8.
Tikkanen J., Kurppa K. and Timonen H. (1988): Cardiovascular malformations, work attendance, and occupational exposures during pregnancy in Finland- Am. J. Ind. Med. 14: 197–284.
Tikkanen J., Heinonen O.P., Kurppa K. and Rantala K. (1989): Cardiovascular malformation and maternal exposure to video display terminals during pregnancy- Eur. J. Epidemiol. 6: 61–66.
Tikkanen J. and Heinonen O.P. (1990): Risk factors for cardiovascular malformations in Finland - Eur. J. Epidemiol. 6: 348–356.
Tikkanen J. and Heinonen O.P. (1991): Maternal exposure to chemical and physical factors during pregnancy and cardiovascular malformations in the offspring - Teratology 43: 591–600.
Tynan M.J., Bercker A.E., Macartney F.J., Jimènez M.O., Shinebourne E.A. and Andersson R.H. (1979): Nomenclature and classification of congenital heart disease - Br. Heart J. 41: 544–553.
VanMierop L.H.S. (1984): Diagnostic code for congenital heart disease - Pediatr. Cardiol. 5: 331–362.
Werler M.A., Pober B.R., Nelson K.G. and Holmes L.B. (1989): Reporting accuracy among mothers of malformed and nonmalformed infants - Am. J. Epidemiol. 129: 415–421.
Workshop to Guidelines to the Epidemiology of Weak Associations (1987): Prev. Med. 16: 139–212.
Author information
Authors and Affiliations
Additional information
Corresponding author.
Rights and permissions
About this article
Cite this article
Tikkanen, J., Heinonen, O.P. Risk factors for atrial septal defect. Eur J Epidemiol 8, 509–515 (1992). https://doi.org/10.1007/BF00146368
Issue Date:
DOI: https://doi.org/10.1007/BF00146368