Associated factors of congenital heart disease among children in a rural health care setting in Sri Lanka

Introduction: Congenital heart disease (CHD) is the commonest congenital abnormality worldwide and carries a high mortality. To determine preventive strategies, information regarding the aetiological factors of CHD in Sri Lanka is essential.

Objectives: To determine the associated factors of CHD in a rural healthcare setting in Sri Lanka.

Method: A case-control study was carried out at Teaching Hospital Anuradhapura (THA) Sri Lanka, from July–December 2019 including 146 participants. Children under 5 years of age, who were diagnosed to have CHD following 2D-echocardiography, were included as cases. A community-based control selection was done including children who had normal 2D-echocardiography. A total of 73 cases and 73 controls were selected. The parents were interviewed using a structured questionnaire after obtaining informed written consent. Data were analysed using SPSS version 23.0. The odds ratio (OR) was used to determine the associated risk factors and the 95% confidence interval (95% CI) was used to determine the statistical significance.

Results: Mothers who used non-steroidal anti-inflammatory drugs (NSAIDs) showed risk associations with CHD (OR 2.02, 95% CI=1.71 – 2.37). Anti-epileptic drug use during the firsttrimester (OR 2.02, 95% CI=1.71–2.39), exposure to fire wood smoke (OR 3.39, 95% CI=1.04–11.2) and paternal exposure to paints (OR 3.39, 95% CI= 1.04-11.2) emerged as significant risk factors of CHD.

Conclusions: In this rural healthcare setting in Sri Lanka, use of antiepileptic drugs, NSAIDs, exposure to firewood smoke and different types of paint during the antenatal period were significantly associated with CHD.

Sri Lanka Journal of Child Health, 2021; 50(2): 203-208