The long-term objective of this case-control study is the identification of environmental risk factors in congenital heart disease (CHD) in order to make possible the reduction of the occurrence of this major birth defect. This is a condinuing application to follow 3 years of field interviews on 960 families of infants with CHD and 1250 control families. The ongoing study is the first detailed epidemiologic study of CHD and is made possible through the joint efforts of five pediatric cardiology centers and 52 regional hospitals which provide access to 90,000 annual births. Preliminary analyses of the initial 1 1/2 year data on 530 cases and 700 controls have yielded findings which suggest genetically vulnerable subpopulations and the possible etiologic role of certain drugs, personal, home and occupational exposures acting as single or as interactive risk factors. Suspect occurrences and exposures are infrequent and confined to subsets of the CHD population so that statistical power can be derived only with a much larger case collection. Continuation of the case-control study to a total of 1,800 cases and 2,500 controls is requested. Concurrent with the field interviews analytic methods will be developed to identify constellations of factors predictive of CHD risks. Final analyses will result in recommendations concerning the identification of vulnerable families and the potential interventions on environmental risk factors. New etiologic hypotheses arising from this work will direct further use of epidemiologic research methods in the study of birth defects.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL025629-07
Application #
3338148
Study Section
Epidemiology and Disease Control Subcommittee 3 (EDC)
Project Start
1980-12-01
Project End
1988-03-31
Budget Start
1986-04-01
Budget End
1987-03-31
Support Year
7
Fiscal Year
1986
Total Cost
Indirect Cost
Name
University of Maryland Baltimore
Department
Type
Schools of Medicine
DUNS #
003255213
City
Baltimore
State
MD
Country
United States
Zip Code
21201
Kuehl, K S; Loffredo, C A; Ferencz, C (1999) Failure to diagnose congenital heart disease in infancy. Pediatrics 103:743-7
Carmi, R; Boughman, J A (1992) Pentalogy of Cantrell and associated midline anomalies: a possible ventral midline developmental field. Am J Med Genet 42:90-5
Carmi, R; Boughman, J A; Ferencz, C (1992) Endocardial cushion defect: further studies of ""isolated"" versus ""syndromic"" occurrence. Am J Med Genet 43:569-75
Ferencz, C; Rubin, J D; McCarter, R J et al. (1990) Maternal diabetes and cardiovascular malformations: predominance of double outlet right ventricle and truncus arteriosus. Teratology 41:319-26
Berg, K A; Astemborski, J A; Boughman, J A et al. (1989) Congenital cardiovascular malformations in twins and triplets from a population-based study. Am J Dis Child 143:1461-3
Maestri, N E; Beaty, T H; Boughman, J A (1989) Etiologic heterogeneity in the familial aggregation of congenital cardiovascular malformations. Am J Hum Genet 45:556-64
Schneider, D S; Zahka, K G; Clark, E B et al. (1989) Patterns of cardiac care in infants with Down syndrome. Am J Dis Child 143:363-5
Martin, G R; Perry, L W; Ferencz, C (1989) Increased prevalence of ventricular septal defect: epidemic or improved diagnosis. Pediatrics 83:200-3
Wilson, P D; Ferencz, C; Dischinger, P C et al. (1988) Twenty-four-hour ambulatory blood pressure in normotensive adolescent children of hypertensive and normotensive parents. Am J Epidemiol 127:946-54
Boughman, J A; Astemborski, J A; Berg, K A et al. (1988) Variation in expression of congenital cardiovascular malformations within and among families. Basic Life Sci 43:93-103

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