Evidence mapPaperPMID 39181550Full record

SynthesisBMJ open2024

Maternal modifiable factors and risk of congenital heart defects: systematic review and causality assessment.

Judith C Gomersall, Vivienne M Moore, Renae C Fernandez, Lynne C Giles, Luke E Grzeskowiak, Michael J Davies, Alice R Rumbold

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Judith C GomersallSchool of Public Health and Lifecourse and Intergenerational Health Research Group, The University of Adelaide, Adelaide, South Australia, Australia judith.gomersall@adelaide.edu.au.ORCID 0000-0002-9148-7162
Vivienne M MooreSchool of Public Health and Lifecourse and Intergenerational Health Research Group, The University of Adelaide, Adelaide, South Australia, Australia.
Renae C FernandezRobinson Research Institute, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia.ORCID 0000-0003-2617-2989
Lynne C GilesSchool of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
Luke E GrzeskowiakWomen and Kids Theme, South Australian Health and Medical Research Institute and College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Michael J DaviesThe Robinson Research Institute and Lifecourse and Intergenerational Health Research Group, The University of Adelaide, Adelaide, South Australia, Australia.
Alice R RumboldWomen and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePrimary prevention strategies are critical to reduce the global burden of congenital heart defects (CHDs); this requires robust knowledge of causal agents. We aimed to review associations between CHDs and maternal advanced age, obesity, diabetes, hypertension, smoking and alcohol consumption and assess the causal nature of the associations.

designSystematic review of reviews with application of a Bradford Hill criteria score-based causal assessment system. DATA SOURCES: We searched PubMed, Embase and Episteminokos (January 1990-April 2023). ELIGIBILITY CRITERIA: Systematic reviews of original epidemiological studies reporting association (relative risk) between one or more of the above maternal factors and CHDs overall (any type) in subsequent offspring. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers selected eligible reviews, assessed the risk of bias and assigned the strength of evidence for causality.

resultsThere was strong evidence of a causal relationship between CHDs and maternal obesity (prepregnancy and early pregnancy) and pre-existing diabetes (six of seven Bradford Hill criteria met). For pre-existing hypertension (strength and biological gradient not met), and advanced age (strength, consistency and biological gradient not met), causal evidence was moderate. Evidence for the causal contribution of gestational diabetes, gestational hypertension, smoking and alcohol consumption was weak (strength, consistency, temporality and biological gradient not met).

conclusionsCHDs can be reduced with stronger action to reduce maternal obesity and pre-existing diabetes prevalence. Investigating environmental exposures that have received limited attention, such as air pollutants and chemical exposures, is important to further inform prevention.

Indexed as

Heart Defects, CongenitalAlcohol DrinkingCausalityDiabetes, GestationalFemaleHumansHypertensionMaternal AgeObesityPregnancyRisk FactorsSmokingcongenital heart diseaseprimary preventionrisk factorssystematic review

Identifiers

PMID39181550
PMCPMC11344500

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.