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Maternal Anaemia and Congenital Heart Disease in Offspring: A Case–Control Study Using Linked Electronic Health Records in the United Kingdom
Author(s) -
Nair Manisha,
Drakesmith Cynthia W.,
Smith Margaret,
Bankhead Clare R.,
Sparrow Duncan B.
Publication year - 2025
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.18150
Subject(s) - medicine , offspring , pregnancy , pediatrics , odds ratio , confounding , population , case control study , iron deficiency , obstetrics , anemia , environmental health , genetics , biology
ABSTRACT Objective Assessment of whether maternal anaemia in early pregnancy is associated with offspring congenital heart disease (CHD). Design Matched case–control study. Setting January 1998–October 2020, United Kingdom. Population Women with a haemoglobin measurement in the first 100 days of pregnancy and a CHD‐diagnosed child. Methods Data were extracted from the United Kingdom Clinical Practice Research Datalink GOLD database of electronic health records. Cases were 2,776 women with a CHD‐diagnosed child. These were compared to 13 880 matched controls, women without a CHD‐diagnosed child. Anaemia was classified as < 110 g/L haemoglobin following the WHO definition. A conditional logistic regression analysis was conducted, adjusted for potential maternal demographic and health‐related confounders. Main Outcome Measures Offspring CHD diagnosed within 5 years of birth. Results 123 (4.4%) cases and 390 (2.8%) controls had anaemia. After adjusting for potential confounders, the odds of giving birth to a CHD‐diagnosed child were 47% higher among anaemic mothers (adjusted OR 1.47, 95% CI 1.18,1.83, p < 0.001). Conclusions The observed association between maternal anaemia in early pregnancy and increased risk of offspring CHD supports our recent evidence in mice. Approximately two‐thirds of anaemia cases globally are due to iron deficiency. A clinical trial of periconceptional iron supplementation might be a minimally invasive and low‐cost intervention for the prevention of some CHD if iron deficiency anaemia is proven to be a cause.