Association between maternal Chlamydia during pregnancy and risk of cyanotic congenital heart defects in the offspring Open Access

Dong, Yan Diane (2014)

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BACKGROUND: Genital Chlamydia is a common bacterial sexually-transmitted infection among reproductive aged women, and particularly, younger populations. Cyanotic congenital heart defects (CCHDs) constitute about one quarter of all cardiac malformations at birth, and are associated with high rate of morbidity and mortality. Epidemiological research on the association between maternal Chlamydia during pregnancy and CCHDs in the offspring is lacking. METHODS: Usingdata from the 2012 U.S. birth certificates, we examined the association between CCHDs and prenatal exposure to Chlamydia among live singleton births with CCHDs (n=2,487) and unaffected singleton births (n= 3,334,424). We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) using unconditional logistic regression analysis for all CCHDs combined, and isolated CCHD (without other major congenital malformations). RESULTS: Overall 1.7% of case and 1.7% of control mothers reported having Chlamydia during their index pregnancies. After controlling for several potential confounders,we found a weak positive association between maternal exposure to Chlamydia during pregnancy and all CCHDs combined (aOR=1.39; 95% CI, 1.02-1.90). A subgroup analysis for high-risk group of mothers aged 15-19 years and 20-24 years during the index pregnancy showed an increased risk for all CCHDs combined and isolated CCHDs; however, the associations were not statistically significant. CONCLUSIONS: Maternal exposure to Chlamydia during pregnancy was weakly associated with an increased risk of CCHDs in the offspring in our study. Future studies should examine the association in other populations, and those at high-risk.

Table of Contents

Introduction 1

Methods 4

Results 7

Discussion 9

References 15

Table 1 21

Table 2a 23

Table 2b 24

Table 3 25

Appendix SAS Code 26

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