Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T05:20:28.507Z Has data issue: false hasContentIssue false
  • English
  • Français

Seasonality in live births with congenital heart disease in Malta

Published online by Cambridge University Press:  19 August 2008

Victor Grech
Victor Grech*
Affiliation:
Paediatric Department, St Luke's Hospital, Guardamangia, Malta
*
Dr Victor Grech MD, PhD, MRCP(UK), DCH, Paediatric Department, St Luke's Hospital, Guardamangia, Malta. Tel: 241251 ext. 1471 (Paediatric Department); Fax: 240176 (St Luke's Hospital); e-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This study was carried out to analyse seasonal variations in live births with congenital heart disease in the overall population of Malta. Included were all patients diagnosed as having congenital heart disease by echocardiography, cardiac catheterization, surgery or post mortem, by 1 year of age, and who were born between in Malta between 1990 and 1994. Results were analysed by χ2 and by Edwards' cyclic method. There were 231 cases of live born congenital heart disease, which were divided into 114 cases not requiring intervention and 117 cases requiring intervention. Although the overall prevalence of congenital heart disease did not demonstrate any seasonal variation, the lesions requiring intervention showed a significant peak in September by Edwards' method (p = 0.03), which was enhanced by seasonal analysis (p = 0.003). These results were confirmed by conventional χ2 and χ2 for trend. The lesions not requiring intervention, which were comprised almost entirely (96%) of mild pulmonary stenosis and small ventricular septal defects, failed to show any seasonal trend. The literature regarding such seasonal trends in these malformations and statistical analysis of seasonality of congenital heart disease are reviewed. An environmental factor such as a maternal viral infection or treatment of such infections during the first trimester of pregnancy from November to January may precipitate congenital heart disease in predisposed Maltese foetuses.

Keywords

Heart defectscongenital epidemiologycongenital aetiologycongenital season
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 4 , July 1999 , pp. 396 - 401
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Grech, V. Spectrum of congenital heart disease in Malta: an excess of lesions causing right ventricular outflow tract obstruction in a population based study. Eur Heart J 1998; 19: 521–525.CrossRefGoogle Scholar
2.Mitchell, SC, Korones, SB, Berendes, HW. Congenital heart disease in 56109 births. Incidence and natural history. Circulation 1971; 43: 323–332.CrossRefGoogle Scholar
3.Ferencz, C, Rubin, JD, McCarter, RJ, Brenner, JI, Neill, CA, Perry, LW, Hepner, SI, Downing, JW. Congenital heart disease: prevalence at livebirth. Am J Epidemiol 1985; 121: 31–36.CrossRefGoogle ScholarPubMed
4. Central Office of Statistics. Demographic Review for the Maltese Islands for the Years 1960–1994. Central Office of Statistics, Malta [annual publications].Google Scholar
5.Edwards, JH. The recognition and estimation of cyclic trends. Ann Hum Genet 1961; 25: 83–87.CrossRefGoogle ScholarPubMed
6.Rothman, KJ, Fyler, DC. Association of congenital heart defects with season and population density. Teratology 1976; 13: 29–34.CrossRefGoogle ScholarPubMed
7.Rothman, KJ, Fyler, DC. Seasonal occurrence of complex ventricular septal defect. Lancet 1974; ii: 193–197.CrossRefGoogle Scholar
8.Samanek, M, Slavik, Z, Miroslav, K. Annual and seasonal variations in the prevalence of congenital cardiac malformations in live-born infants. Cardiol Young 1992; 2: 152–157.CrossRefGoogle Scholar
9.Kenna, AP, Smithells, RW, Fielding, DW. Congenital heart disease in Liverpool: 1960–69. Q J Med 1975; 173: 17–44.Google Scholar
10.Miettinen, OS, Reiner, ML, Nadas, AS. Seasonal incidence of coarctation of the aorta. Br Heart J 1970; 32: 103–107.CrossRefGoogle ScholarPubMed
11.Roberts, CJ, Lowe, CR, Lloyd, S. Cyclic variations in date of last menstrual period of mothers of infants with congenital malformations in South Wales, 1964–66. Br J Prev Soc Med 1972; 26: 212–218.Google ScholarPubMed
12.Edwards, JH. Seasonal incidence of congenital heart disease in Birmingham. Ann Hum Genet 1961; 25: 89–93.CrossRefGoogle Scholar
13.Rosenberg, LA, Heinonen, OP. Seasonal occurrence of ventricular septal defect. Lancet 1974; ii: 903–904 [letter].CrossRefGoogle Scholar
14.Tikkanen, J, Heinonen, OP. Risk factors for hypoplastic left heart syndrome. Teratology 1994; 50: 112–117.CrossRefGoogle ScholarPubMed
15.Bartsocas, CS. Seasonal variation of patent ductus arteriosus. Lancet 1975; i: 109 [letter].CrossRefGoogle Scholar
16.Tikkanen, J, Heinonen, OP. Risk factors for coarctation of the aorta. Teratology 1993; 47: 565–572.CrossRefGoogle ScholarPubMed
17.Hummel, DB, Dansky, R, Leahy, B, Levin, SE. A disproportionately high incidence of symptomatic coarctation of the aorta in white infants in the Transvaal. S Afr Med J 1988 23; 73: 93–95.Google Scholar
18.Boon, AR, Roberts, DF. A family study of coarctation of the aorta. J Med Genet 1976; 13: 420–433.CrossRefGoogle ScholarPubMed
19.Tikkanen, J, Heinonen, OP. Maternal hyperthermia during pregnancy and cardiovascular malformations in the offspring. Eur J Epidemiol 1991; 7: 628–635.CrossRefGoogle ScholarPubMed
20.Vesterby, A, Nielsen, K, Borg, L, Paulsen, S, Baandrup, U. Congenital heart malformations in Jutland, Denmark: a three year necropsy study in children aged 0–14 years. Epidemiology and classification according to sequential segmental analysis. Br Heart J 1987; 58: 653–658.CrossRefGoogle Scholar
21.Schmaltz, AA, Schaible, T, Apitz, J. Special heart diagnosis in the 1st year of life. An analysis of 1,131 infants with congenital heart defects 1972–1983. Monatsschr Kinderheilkd 1989; 137: 144–150.Google Scholar
22.Laursen, HB. Some epidemiological aspects of congenital heart disease in Denmark. Acta Paediatr Scand 1980; 69: 619–624.CrossRefGoogle ScholarPubMed
23.Nora, JJ. From generational studies to a multilevel genetic–environmental interaction. J Am Coll Cardiol 1994; 23: 1468–1471.CrossRefGoogle ScholarPubMed
24.Grech, V. Epidemiology and diagnosis of ventricular septal defect in Malta. Cardiol Young 1998; 8: 329–336.CrossRefGoogle ScholarPubMed
25.Grech, V. History, diagnosis, surgery and epidemiology of pulmonary stenosis, in Malta. Cardiol Young 1998; 8: 337–343.CrossRefGoogle ScholarPubMed