Birth Outcomes of Cases with Single Ventricle Complex – A Population-Based Case-Control Study
Attila Vereczkey
Versys Clinics, Human Reproduction Institute, Budapest, 1138, Madarász Viktor utca 47-49, Hungary
Melinda Csáky-Szunyogh
National Centre for Healthcare Audit and Inspection, Budapest, 1096, Nagyvárad tér 2. Hungary
Balázs Gerencsér
Alfréd Rényi Institute of Mathematics, Hungarian Academy of Science, Budapest, 1053, Reáltanoda utca 13-15, Hungary
Andrew E. Czeizel *
Foundation for the Community Control of Hereditary Diseases, Budapest 1026, Törökvész lejtő 32, Hungary
*Author to whom correspondence should be addressed.
Abstract
Aims: The aim of this paper was to study the birth outcomes of cases with single ventricle complex (SVC), a rare congenital heart defect, as homogeneously as possible.
Study Design: For the analysis of cases, the large dataset of the population-based Hungarian Case-Control Surveillance of Congenital Abnormalities was used.
Place and Duration of Study: The study was conducted in Budapest based on the data set of the HCCSCA between 1980 and 1996 but the follow-up of cases was performed in 2008-2011.
Methodology: Syndromic/multiple cases with the component SCV were excluded and only live-born cases based on autopsy report in lethal cases and on medical documents after surgical correction were included to the study. Medically recorded birth outcomes of 76 cases with SVC and 38,151 population controls without defect were compared but maternal socio-demographic variables as confounders were considered.
Results: A higher rate of twins (5.3% vs. 1.0%; OR with 95% CI: 5.11, 1.55-12.40) was observed in cases compared to population controls. The rate of low birthweight (18.4% vs. 5.7%; OR with 95% CI: 4.84, 2.23-9.71) was higher in cases than in population controls. Among maternal variables the higher birth order 3 or more (25.0% vs. 14.8%, p=0.04) and pregnancy order (p = 0.0005) are noteworthy, the latter is explained by the higher rate of miscarriages in previous pregnancies of case mothers.
Conclusion: The higher rate of twins and low birthweight suggest some association with the origin of SCV.
Keywords: Single ventricle complex, twins, low birthweight, birth/pregnancy order, population-based case-control study