Background: Congenital Heart Defects (CHDs) are the most common structural defects of newborns (5-15 per 1000 live births). Southern Israel population comprises of Jewish population (80%) and Bedouin Arabs (20%), who have a high rate of consanguinity and a low abortions rate.
Aims: To assess the CHD epidemiology and the association with maternal characteristics.
Methods: A population-based study of all births during 1991-2011 in Soroka University Medical Center (SUMC), a tertiary hospital admitting all
births in the area (n=253,240) with 7,607 newborns having CHD. To account for the same woman deliveries a general estimating equation (GEE) models adjusted for gender and parity were used.
Results: The incidence of CHDs was 30 per 1,000 live births, increasing over the last 20 years from 7.6 to 37.9, with a peak incidence in 2006 of 45.5 with majority (60.7 %) observed in Bedouin Arabs. The most common defects were ventricular septal defect (27.7%) and atrial septal defect (16.3%). Maternal risk factors included maternal CHD (adjusted odds ratio [aOR] 2.84, p<0.001), CHD in other children (aOR 19.3, p<0.001), maternal age>35 (aOR 1.3, p<0.001), Bedouin descent (aOR 1.16, p<0.001),
in-vitro fertilization (aOR 1.52, p=0.001), recurrent miscarriages (aOR 1.2, p<0.001), diabetes mellitus (aOR 2.12, p<0.001), anemia (aOR 1.25, p<0.001) and chronic hypertension (aOR 1.26, p=0.005).< p>
Conclusions: Southern Israel has a significantly higher incidence of CHD than reported in other countries. Several maternal factors are associated with CHDs such as maternal or sibling CHD, miscarriages, fertility treatments and a number of chronic conditions. The latter includes anemia and chronic hypertension, which were not reported in previous studies and could influence future treatments such as iron supplements as part of CHD prevention. The incidence of CHDs has increased over the last 20 years, either due to a rise in diagnosis or a true rise requiring further investigation.
