To explore the probability of a relationship between the maternal psychological stress events during the periconceptional period and the incidence of fetal ventricular septal defects, in urban Texas population.
Heart develops during early fetal life - it starts with a hollow…
ency, misalignment or failure of fusion of the components of the interventricular septum, viz., endocardial cushions, aorticopulmonary septum and the muscular part of the septum, is the primary cause of the ventricular septal defects (Shinebourne et al, 2006). A hole or complete absence of the septum allows the blood to mix in the ventricles, which is supplied to the lungs as well as the rest of the body giving rise to symptoms like ‘blue babies’. Soto et al (1980) gave an objective classification of the ventricular septal defects (VSD). On the basis of angiograms of 220 children with VSD, they observed that the defects in the septum could present with the following morphologies - perimembranous defects; muscular defects and subarterial infundibular defects. Perimembranous defects as well as the muscular defects were further divided into three sub-groups each.
A stressful life of the mother has been studied as a risk factor for a number of congenital malformation in the offspring, e.g. orofacial cleft (Montenegro et al, 1995), neural tube defects (Carmichael and Shaw, 2000) and conotruncal heart defects (Suarez, 2003). Carmichael et al (2007) have conducted a comprehensive population based case-control study involving 1355 mothers and calculated a ‘stressful life event score’ based on exposure to 18 possible stress-events and its association with congenital birth defects. Their results showed that a 3-point increase in the stress score increases the odds-ratio of a birth defect to 1.45 ( C.I. 1.03-2.06) and the risk is further aggravated to O.R. of 2.35 (CI = 1.47 – 3.77), if the mother is not taking vitamin (folic acid) supplement during early pregnancy. Hansen et al (2000), in a rare 12 year prospective study with a 16 months retrospective component, reported an increased incidence of cranial-neural-crest malformations as well as other congenital malformations in children born to mothers exposed to severe life events like death, hospitalization for ...
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