Maternal Heart Disease Linked to Higher Risk of Congenital Heart Disease in Offspring: JAMA
China: A large study from China found a significant association between maternal heart disease during pregnancy and an increased risk of congenital heart disease (CHD) in children during their first year of life. The findings, published in JAMA Network Open, suggest that maternal cardiovascular health plays an important role in fetal heart development.
Researchers emphasized that early identification and management of modifiable maternal risk factors, along with targeted monitoring during pregnancy, may help reduce the risk of congenital heart disease in offspring.
The study, led by Yanji Qu of Southern Medical University, Guangzhou, China, examined the association between maternal cardiac disease and congenital heart disease (CHD) in offspring.
To investigate this relationship, researchers conducted a prospective birth cohort study involving pregnant women with congenital heart disease, acquired heart disease, or no cardiac disease who received prenatal care at a major cardiac referral center in China between 2011 and 2021. Mothers were followed through delivery, and their children were monitored until one year of age.
The analysis included 14,336 women and 15,677 offspring. Using echocardiography, the researchers assessed the risk of CHD in children and evaluated the association between maternal heart disease, specific CHD subtypes, and related outcomes.
Key findings from the study included:
- Maternal congenital heart disease was associated with a 71% higher risk of congenital heart disease in offspring.
- Maternal acquired heart disease was associated with a 38% increased risk of congenital heart disease in children.
- Septal defects were the most strongly associated CHD subtype in offspring of mothers with either congenital or acquired heart disease.
- Right ventricular outflow tract obstruction and maternal valvular heart disease emerged as important contributors to offspring CHD risk.
- Among children with CHD, those born to mothers with congenital heart disease had higher rates of preterm birth.
- Children with CHD born to mothers with acquired heart disease showed increased rates of chromosomal and genetic abnormalities.
- The associations were particularly pronounced among first-time mothers and women exposed to hazardous substances around the time of conception.
The investigators suggested that maternal cardiac disease may affect fetal heart development through genetic, environmental, and physiological pathways, underscoring the importance of maternal health in assessing fetal risk.
The researchers noted that the single-center design may limit generalizability, and residual confounding from unmeasured genetic, epigenetic, or medication-related factors cannot be ruled out.
Overall, maternal congenital and acquired heart disease were associated with higher risks of congenital heart disease and adverse outcomes in offspring. The authors emphasized the need for targeted surveillance, risk-factor modification, and specialized prenatal care in this high-risk population.
Reference:
Qu Y, Liu X, Lin S, et al. Maternal Cardiac Disease and Congenital Heart Disease Risk in Offspring. JAMA Netw Open. 2026;9(5):e2610823. doi:10.1001/jamanetworkopen.2026.10823
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