CHD incidence in offspring of mothers with non-inherited and non-syndromic forms of CHD: a single-centre retrospective cohort study

INTRODUCTION: CHD affect approximately 1% of live births globally and are the most common congenital anomaly. Contemporary data on CHD risk in offspring of affected mothers remains limited. This study evaluated CHD incidence in offspring of mothers with CHD at a southeastern U.S. academic medical centre. METHODS: We conducted a retrospective review of patients with CHD who received prenatal care between 2015 and 2023 at a multidisciplinary Cardio-Obstetrics clinic. Patients with acquired heart disease, syndromic or inherited CHD, and deliveries at outside hospitals with missing delivery data were excluded. The primary outcome was infant CHD incidence, confirmed by postnatal echocardiography. Secondary outcomes were neonatal intensive care unit admission, early in-hospital cardiac surgery, and in-hospital infant mortality. RESULTS: A total of 186 mothers with 195 pregnancies and 198 infants were included. CHD was diagnosed in 16 infants (8.1%), most commonly ventricular septal defect. Of affected infants, none required early in-hospital surgery, and one experienced in-hospital mortality, though this infant had severe extracardiac anomalies concerning an underlying genetic syndrome. CONCLUSION: The incidence of CHD among offspring of mothers with CHD in our cohort was higher than the general population; however, the majority of defects were non-critical and did not require early intervention. These findings offer important context for prenatal counselling and tailored fetal/neonatal echocardiography screening in this high-risk population.