The risk of giving birth to a child with congenital heart disease (CHD) is approximately 50 per cent higher for mothers with anaemia compared to those without, research has found.
Researchers suggest the findings, published in BJOG: An International Journal of Obstetrics & Gynaecology, have the potential to substantially reduce the number of children born with CHD, currently estimated as approximately 2.5 million annually.
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Using data from the UK Clinical Practice Research Datalink GOLD database of electronic health records, the researchers analysed electronic health records from 2,776 women who had a child diagnosed with CHD. These cases were matched to 13,880 women whose children did not have a CHD diagnosis.
The researchers used the WHO definition of anaemia (< 110 g/L haemoglobin) and analysed women with a haemoglobin measurement in the first 100 days of pregnancy and a CHD-diagnosed child within the first five years of life.
The findings showed that of 123 mothers whose babies had CHD, 4.4 per cent of the women had anaemia. Of the 390 mothers whose babies had normal heart function, 2.8 per cent of the mothers had anaemia. After adjusting for potential influencing factors, the odds of giving birth to a child with congenital heart disease were 47 per cent higher among anaemic mothers.
Duncan Sparrow, PhD, from the University of Oxford and the corresponding author on the work, said: ‘We already know that the risk of congenital heart disease can be raised by a variety of factors, but these results develop our understanding of anaemia specifically and take it from lab studies to the clinic. Knowing that early maternal anaemia is so damaging could be a game-changer worldwide.’
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The Population Attributable Fraction (PAF) was calculated to be 1.4 per cent from the 2.8 per cent prevalence in the population measured. However, previous estimates suggest levels of anaemia may be as high as seven per cent in the first trimester and up to 13 per cent in some areas. In these cases, maternal anaemia may account for up to 6.2 per cent of UK CHD cases.
Dr Sparrow added: ‘Because iron deficiency is the root cause of many cases of anaemia, widespread iron supplementation for women – both when trying for a baby and when pregnant – could help prevent congenital heart disease in many newborns before it has developed.’
The researchers suggest a clinical trial of periconceptional iron supplementation would be beneficial in light of their results, stating it would be a minimally invasive and low-cost intervention which could prevent some CHD if iron deficiency anaemia is proven to be a cause.
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Reference: M Nair, CW Drakesmith, M Smith, CR Bankhead, DB Sparrow. Maternal Anaemia and Congenital Heart Disease in Offspring: A Case–Control Study Using Linked Electronic Health Records in the United Kingdom https://doi.org/10.1111/1471-0528.18150
