title: Risk factors of different congenital heart defects in Guangdong, China.
abstract: BACKGROUND
  Limited studies have evaluated the risk factors for congenital heart defects (CHDs) in China and compared them for different types of CHDs. This study examined risk factors between isolated and multiple CHDs as well as among CHDs subtypes in Guangdong, Southern China.
  
  
  METHODS
  This population-based case-control study included 4,034 pairs of case and control infants enrolled in the Guangdong Registry of CHD study, 2004-2013. Multivariate logistic regression was used to compute adjusted odds ratios (ORs) while simultaneously controlling for confounders.
  
  
  RESULTS
  Multiple maternal environmental exposures, including living in newly renovated rooms, residential proximity to main traffic, paternal smoking, and maternal occupation as manual worker, were significantly associated with CHDs with ORs ranging 1.30-9.43. Maternal perinatal diseases (including maternal fever, diabetes, influenza, and threatened abortion), maternal medication use (antibiotic use), advanced maternal age, low socioeconomic status, and paternal alcohol intake were also significantly associated with CHDs, with ORs ranging 1.60-3.96. Isolated CHDs and multiple defects have different profiles of risk factors, while subtype of CHD shares common risk factors.
  
  
  CONCLUSIONS
  These results suggest that maternal environmental exposures/occupation and perinatal diseases/medication use were dominant risk factors associated with CHDs in Southern China. Isolated and multiple CHDs may have different etiologic factors.
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Yanqiu
authors.initials: Y
authors.lastname: Ou
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Jinzhuang
authors.initials: J
authors.lastname: Mai
authors.affiliation: Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhuang
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Xiangmin
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Nie
authors.affiliation: Department of Cardiovascular Disease Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Yanji
authors.initials: Y
authors.lastname: Qu
authors.affiliation: Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital (Guangdong Academic of Medical Science), Guangzhou, Guangdong, China.
authors.forename: Jimei
authors.initials: J
authors.lastname: Chen
authors.affiliation: Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, New York.
authors.forename: Christine
authors.initials: C
authors.lastname: Kielb
authors.affiliation: Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, New York.
authors.forename: Ursula
authors.initials: U
authors.lastname: Lauper
authors.affiliation: Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, New York.
authors.forename: Shao
authors.initials: S
authors.lastname: Lin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D012307:Risk Factors