Risk factors

Anyone can have a child with a congenital heart defect. The risk of any one mother giving birth to a child with congenital heart defects is about 1 percent.

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If you have a relative with a heart defect or already have a child with a defect, the chances of problems in your future children does rise slightly. However, unless a specific chromosomal problem is identified, or a clear pattern of hereditary heart disease is seen in a family tree, most experts believe the risk that a developing embryo will acquire a heart defect is about 2 to 5 percent. In other words, there is a 95 to 98 percent chance of a baby being born without a heart defect.

Approximately 10 percent of congenital heart defects are associated with a chromosomal abnormality. One third of the children with Down's syndrome also have a congenital heart defect, as do one quarter of the girls with Turner syndrome. Children with Down and Turner syndromes should be evaluated for congenital heart defects.

The following factors are associated with an increased risk of congenital heart disease:

• Exposure of the mother to viral infections - Women who contract the virus rubella, commonly known as German measles, during the first few weeks of pregnancy have an increased risk of having a baby with a heart defect. Women who contract upper respiratory tract infections in the early stages of pregnancy-even minor ones-may also be at increased risk.
• Exposure of the mother to certain medications and street drugs. Women who take medicines such as the acne medication isotretinoin (brand name Accutane), lithium (commonly prescribed for bipolar disorder), and possibly some antiseizure medications put the developing fetus at increased risk for congenital heart disease. Drinking alcohol and using cocaine while pregnant also puts a fetus at increased risk.
• Repeated exposure to X-rays and strong chemicals such as solvents.
• Maternal health. Women with diabetes are at increased risk of having a baby with a congenital heart defect, as are women who develop phenylketonuria (PKU) during pregnancy. In both these cases, these risks can be minimized through proper management and diet.