The changing epidemiology of Ebstein's anomaly and its relationship with maternal mental health conditions: a European registry-based study.

Détails

ID Serval
serval:BIB_CCE740B1061F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The changing epidemiology of Ebstein's anomaly and its relationship with maternal mental health conditions: a European registry-based study.
Périodique
Cardiology in the young
Auteur(s)
Boyle B., Garne E., Loane M., Addor M.C., Arriola L., Cavero-Carbonell C., Gatt M., Lelong N., Lynch C., Nelen V., Neville A.J., O'Mahony M., Pierini A., Rissmann A., Tucker D., Zymak-Zakutnia N., Dolk H.
ISSN
1467-1107 (Electronic)
ISSN-L
1047-9511
Statut éditorial
Publié
Date de publication
05/2017
Peer-reviewed
Oui
Volume
27
Numéro
4
Pages
677-685
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The aim of this study was to describe the epidemiology of Ebstein's anomaly in Europe and its association with maternal health and medication exposure during pregnancy.
We carried out a descriptive epidemiological analysis of population-based data.
We included data from 15 European Surveillance of Congenital Anomalies Congenital Anomaly Registries in 12 European countries, with a population of 5.6 million births during 1982-2011. Participants Cases included live births, fetal deaths from 20 weeks gestation, and terminations of pregnancy for fetal anomaly. Main outcome measures We estimated total prevalence per 10,000 births. Odds ratios for exposure to maternal illnesses/medications in the first trimester of pregnancy were calculated by comparing Ebstein's anomaly cases with cardiac and non-cardiac malformed controls, excluding cases with genetic syndromes and adjusting for time period and country.
In total, 264 Ebstein's anomaly cases were recorded; 81% were live births, 2% of which were diagnosed after the 1st year of life; 54% of cases with Ebstein's anomaly or a co-existing congenital anomaly were prenatally diagnosed. Total prevalence rose over time from 0.29 (95% confidence interval (CI) 0.20-0.41) to 0.48 (95% CI 0.40-0.57) (p<0.01). In all, nine cases were exposed to maternal mental health conditions/medications (adjusted odds ratio (adjOR) 2.64, 95% CI 1.33-5.21) compared with cardiac controls. Cases were more likely to be exposed to maternal β-thalassemia (adjOR 10.5, 95% CI 3.13-35.3, n=3) and haemorrhage in early pregnancy (adjOR 1.77, 95% CI 0.93-3.38, n=11) compared with cardiac controls.
The increasing prevalence of Ebstein's anomaly may be related to better and earlier diagnosis. Our data suggest that Ebstein's anomaly is associated with maternal mental health problems generally rather than lithium or benzodiazepines specifically; therefore, changing or stopping medications may not be preventative. We found new associations requiring confirmation.

Mots-clé
Adolescent, Adult, Antidepressive Agents/adverse effects, Benzodiazepines/adverse effects, Ebstein Anomaly/epidemiology, Ebstein Anomaly/etiology, Europe/epidemiology, Female, Fetal Death, Humans, Infant, Newborn, Lithium/adverse effects, Male, Maternal Exposure/adverse effects, Mental Disorders/drug therapy, Pregnancy, Pregnancy Outcome/epidemiology, Pregnancy Trimester, First, Registries, Young Adult, beta-Thalassemia/etiology, Ebstein’s anomaly, antidepressants, mental illness, prevalence, psycholeptics
Pubmed
Web of science
Open Access
Oui
Création de la notice
19/06/2017 17:42
Dernière modification de la notice
20/08/2019 16:47
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