title: Association of maternal chronic disease with risk of congenital heart disease in offspring.
abstract: BACKGROUND
  Information about known risk factors for congenital heart disease is scarce. In this population-based study, we aimed to investigate the relation between maternal chronic disease and congenital heart disease in offspring.
  
  
  METHODS
  The study cohort consisted of 1 387 650 live births from 2004 to 2010. We identified chronic disease in mothers and mild and severe forms of congenital heart disease in their offspring from Taiwan's National Health Insurance medical claims. We used multivariable logistic regression analysis to assess the associations of all cases and specific types of congenital heart disease with various maternal chronic diseases.
  
  
  RESULTS
  For mothers with the following chronic diseases, the overall prevalence of congenital heart disease in their children was significantly higher than for mothers without these diseases: diabetes mellitus type 1 (adjusted odds ratio [OR] 2.32, 95% confidence interval [CI] 1.66-3.25), diabetes mellitus type 2 (adjusted OR 2.85, 95% CI 2.60-3.12), hypertension (adjusted OR 1.87, 95% CI 1.69-2.07), congenital heart defects (adjusted OR 3.05, 95% CI 2.45-3.80), anemia (adjusted OR 1.31, 95% CI 1.25-1.38), connective tissue disorders (adjusted OR 1.39, 95% CI 1.19-1.62), epilepsy (adjusted OR 1.37, 95% CI 1.08-1.74) and mood disorders (adjusted OR 1.25, 95% CI 1.11-1.41). The same pattern held for mild forms of congenital heart disease. A higher prevalence of severe congenital heart disease was seen only among offspring of mothers with congenital heart defects or type 2 diabetes.
  
  
  CONCLUSIONS
  The children of women with several kinds of chronic disease appear to be at risk for congenital heart disease. Preconception counselling and optimum treatment of pregnant women with chronic disease would seem prudent.
authors.affiliation: Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Hsin-Hsu
authors.initials: HH
authors.lastname: Chou
authors.affiliation: Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Meng-Jiun
authors.initials: MJ
authors.lastname: Chiou
authors.affiliation: Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Fu-Wen
authors.initials: FW
authors.lastname: Liang
authors.affiliation: Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Lea-Hua
authors.initials: LH
authors.lastname: Chen
authors.affiliation: Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Lu
authors.affiliation: Department of Pediatrics (Chou), Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan; Department of Applied Life Science and Health (Chou), College of Human Ecology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; Institute of Public Health, College of Medicine (Chiou, Liang, Lu, Li), National Cheng Kung University, Tainan, Taiwan; Department of Statistics (Chen), Ministry of Health and Welfare, Taipei, Taiwan; Department of Public Health (Li), College of Public Health, China Medical University, Taichung, Taiwan cyli99@mail.ncku.edu.tw.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology*; D002908:Chronic Disease; D015331:Cohort Studies; D003240:Connective Tissue Diseases / Q000453:epidemiology*; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007231:Infant, Newborn; D016015:Logistic Models; D019964:Mood Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology