Folic Acid May Play Role in Prevention of Congenital Heart Defects

A study in the March 2006 issue of European Heart Journal by the Children's Heart Center in the Netherlands has reported that mothers with certain gene variants for folate metabolism have an increased risk of conotruncal heart defects in their children if they do not take folic acid in the periconceptual period. These findings suggest a protective role for folate supplementation in the prevention of conotruncal heart defects in mothers with these gene variants.

Maternal MTHFR 677C>T is a risk factor for congenital heart defects: effect modification by periconceptional folate supplementation.
Eur Heart J. 2006 Mar 7

Heart Defects #1 Birth Defect

February 15th is Congenital Heart Defect Awareness Day, a day that recognizes the No. 1 birth defect in the United States. According to the American Heart Association, almost twice as many children in the U.S. die from congenital heart defects as from all forms of childhood cancer combined. Congenital heart defects occur in approximately 1 in every 100 births.
Of the 35 known congenital heart defects, Hypoplastic Left Heart Syndrome (HLHS) is considered to be one of the worst. In HLHS, the left side of the heart is underdeveloped. It occurs in approximately one of every 6,000 births.
Fifteen years ago, it was a virtual death sentence. HLHS cannot be "fixed", but while current surgical treatment cannot cure HLHS, it can lengthen the lives of babies born with it. For more information on congenital heart defects, visit http://tchin.org or www.americanheart.org.

FDA Requires Stronger Warning on Paxil

The Food and Drug Administration (FDA) is requiring a stronger warning that the antidepressant Paxil may be associated with birth defects. A second study found increased risk of fetuses developing heart defects when their mothers took Paxil during pregnancy.

The FDA asked manufacturer GlaxoSmithKline PLC to reclassify the drug as a ``Category D'' drug for pregnant women. The classification means that studies in pregnant women have shown a risk to the fetus.

Two studies of pregnant women taking Paxil during their first trimester have now shown their babies have heart defects one and a half to two times a greater rate than the norm, the FDA said. The agency announced the strengthened warning on December 8th. It issued a previous warning in September.

The FDA is advising doctors not to prescribe Paxil to women in their first three months of pregnancy or women who are planning to become pregnant, unless there are no other treatment options. (from Associated Press news report)

Folic Acid May Prevent Some Heart, Skeletal, Stomach and Kidney Defects

According to a study recently published in Birth Defects Research (Part A), mandatory fortification of the U.S. grain supply with folic acid may have helped to reduce the rate of transposition of the great arteries, cleft palate, pyloric stenosis, limb reduction defects and omphalocele (organs outside the abdomen). In Hispanic women, substantial decreases were also noted for renal agenesis (a fatal kidney defect) and common truncus (a heart defect). Upper limb reduction defects also decreased among children born to Hispanics. The study was conducted by the National Birth Defects Prevention Network.

Canfield MA, Collins JS, Botto LD et al. Changes in the Birth Prevalence of Selected Birth Defects after Grain Fortification with Folic Acid in the United States: Findings from a Multi-State Population Based Study. Birth Defects Research, Part !. 2005-73:679-689.

Paxil Associated with Increase in Congenital Heart Defects

Drug Company Study Associates Paxil With Increase In Congenital Heart Defects

The Food and Drug Administration is warning that the antidepressant drug Paxil may be associated with increases in birth defects. A study by GlaxoSmith Kine has found increased numbers of babies born with birth defects to women who were taking Paxil during the first trimester of pregnancy. The most significant risk was for congenital heart defects. The FDA released a letter from the manufacturer on Tuesday with a warning to health care professionals about the new study results. : http://www.fda.gov/

chds and the environment

Congenital Heart Defects Doubled in Neighborhood with Chemical Spill

Babies born in a polluted neighborhood in Endicott, New York have more than double the expected rate of congenital heart defects. The Department of Health has documented at least 15 cases of CHDs over a 17-year period in a neighborhood of only 2,600 people. The neighborhood, where the high rate of heart defects has been documented, is polluted by an underground plume of chemical vapors from an electronics manufacturer. One of the main toxic chemicals in the neighborhood is trichloroethylene (TCE), once widely used in the electronics industry. Studies have linked TCE with heart defects and other birth defects like cleft lip and palate.

From Press and Sun Bulletin. Binghamton NY Sept. 18, 2005.

chds and the environment

Risk of CHDs increased in offspring of women with diabetes.

To evaluate the effect of pre-gestational diabetes on pregnancy outcome, cases with congenital abnormalities were identified in the population-based Hungarian Congenital Abnormality Registry from 1980 to 1996 with two newborn children without congenital abnormality selected from the National Birth Registry as controls.
Pre-gestational maternal diabetes was associated with strong teratogenic effects on the kidney, urinary tract, and heart, and strongly associated with multiple congenital abnormalities.
The association was strongest for the following congenital abnormalities: renal agenesis (POR: 14.8; 95% CI, 3.5-62.1), obstructive congenital abnormalities of the urinary tract (POR: 4.3; 95% CI, 1.3-13.9), cardiovascular congenital abnormalities (POR: 3.4; 95% CI, 2.0-5.7), and multiple congenital abnormalities (POR: 5.0; 95% CI, 2.4-10.2).

Diabet Med. 2005 Jun;22(6):693-6.