1-3 % of all live births
	20-25 % in preterm infants
	85% in preterm with a birthweight < 800 grams Due to the presence of the PDA
	Risk increases 1-3% if: Mother herself has history of CHD Mother has previously given birth to child/children with CHD

Genetic Syndromes Trisomy 13 (Pautau’s) Commonly have VSD, PDA Trisomy 18 (Edward’s) Commonly have VSD, PDA Trisomy 21 (Down) Commonly have ASD, VSD, AV canal, PDA Turner’s Commonly have Coarctation of aorta, aortic valve stenosis Chromosomal Deletions Usually involves chromosomes # 4, 5, 13, or 18 Varying defects ranging from simple to complex

VACTERL Syndrome Acronym for congenital multi-system defects Must have at least 3 of included defects to receive this diagnosis

Stands for: Vertebral defects Neural tube defect Anorectal defects Anal atresia w/wo a fistula Cardiac VSD, dextracardia, valve defects Tracheo-Esophageal fistula Many times with esophageal atresia Renal Polycystic kidneys, hydronephrosis, agenesis of 1 kidney Look for 1 umbilical artery instead of 2 Limb Deformity of thumb, hypoplasia of digits, syndactyl or polydactyl (less or more fingers or toes)

Maternal substance use Alcohol  VSD w/wo subpulmonic & subaortic stenosis Coarctation of aorta, aortic regurgitation ASD, Tetralogy of Fallot Drugs Thalidomide--various defects Anticonvulsants--VSD, PDA, coarctation of aorta, hypertrophy of ventricles Antineoplastics--dextracardia Lithium--Ebstein’s anomaly, ASD, tricuspid atresia

©Toxins Asbestos Paint Textiles Varying defects ranging from simple to complex

©Safety Loss of perfusion and/or oxygenation to the mother or placenta can result in a defect depending on timing of insult About 2% of CHD can be attributed to environmental issues (drugs, alcohol, toxins, safety)

Maternal Health Diabetes Transposition of great vessels, VSD, PDA, coarctation of aorta Infection PDA, pulmonary stenosis May be bacterial or viral illness Chronic Respiratory Lupus Either may interfere with perfusion and oxygenation of developing organs Previous history of CHD in mother herself or previous sibling