title: Congenital heart defects after maternal fever.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether maternal febrile illnesses in early pregnancy are associated with increased risk for congenital heart defects in the offspring and whether such risk is mitigated by multivitamin supplement use.
  
  
  METHODS
  From a multistate population-based case-control study (National Birth Defects Prevention Study), we compared maternal reports of first-trimester febrile illness from 7020 subjects with heart defects and 6746 unaffected control subjects who were born from 1997 through 2005. Relative risks were computed with no fever or infection during the first trimester as reference group and were adjusted for potential confounders.
  
  
  RESULTS
  First-trimester febrile illness was reported by 7.4% of control mothers (1 in 13). Febrile genitourinary infections were associated with selected heart defects, particularly right-sided obstructive defects (odds ratios, >3) and possibly others, whereas common respiratory illnesses were associated with low-to-negligible risks for most heart defects. When risk estimates were elevated, they tended to be mitigated when multivitamin supplements had been taken in the periconceptional period.
  
  
  CONCLUSIONS
  The source of fever and the use of supplements appear to influence the risk for heart defects. This information can be helpful in counseling and research, in particular with regard to primary prevention.
authors.affiliation: Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT. Electronic address: lorenzo.botto@hsc.utah.edu.
authors.forename: Lorenzo D
authors.initials: LD
authors.lastname: Botto
authors.affiliation: Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Janice D
authors.initials: JD
authors.lastname: Panichello
authors.affiliation: Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, NY.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Browne
authors.affiliation: Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Sergey
authors.initials: S
authors.lastname: Krikov
authors.affiliation: Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Feldkamp
authors.affiliation: Children's Hospital Oakland Research Institute, Oakland Children's Hospital, Oakland, CA.
authors.forename: Edward
authors.initials: E
authors.lastname: Lammer
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Shaw
mesh_terms: D058633:Antipyretics / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000453:epidemiology*; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D058633:Antipyretics; D014815:Vitamins
keywords: congenital heart defect; fever; infection; prevention