The number of newborns born with congenital heart defects at Trinity Hospital in Minot is about average, a neonatologist with the hospital said.
"I think we're probably right in line with the national average, and that's probably somewhere between six to 10 per thousand," said Dr. Thomas Carver. "That would be somewhere between 12 and 15 a year (at Trinity)."
The issue of congenital heart defects defects that are present at birth are being highlighted by the N.D. Department of Health through "And The Beat Goes On ... Looking To The Future For Healthy Hearts," a campaign held during January, which is National Birth Defects Prevention Month.
Article Photos
Submitted Photo - - Dr. Thomas Carver, a neonatologist with Trinity Health, cares for an infant in the Newborn Intensive Care Unit at Trinity. Carver said that about 12 to 15 cases of congenital heart defects are seen at Trinity annually, a statistic that seems to fall in line with the national average.
"This is an important health concern and our goal is to make sure everyone is aware of both the possible prevention measures and early detection steps," said Devaiah Muccatira, with the department's Division of Children's Special Health Services.
Followed by low birth weight and premature birth, congenital heart defects are the leading cause of infant mortality in the United States, said Dr. David Billings, an OB/GYN at Trinity. According to a 2010 report from the department, there were 39,955 live births in North Dakota between 2001 and 2005, and of these, 3 percent, or 1,240, had "major" congenital anomalies, although some live births may have one or more congenital anomaly.
Defects
The most common congenital heart defect is the atrial septal defect, which from 2004 to 2008 affected about 65 per 10,000 births, the 2010 report stated. An atrial septal defect is a hole in the wall that separates the two upper chambers of the heart. This hole then disrupts the flow of blood and oxygen to the body.
Congenital heart defects can be discovered during an ultrasound taken at 20 weeks of development, at which time the heart is looked at, Billings said.
"Sometimes, the incidence of picking up heart disease on a fetal ultrasound ... it does occur, but they can miss a lot of them as well," Carver said. "Almost all women have prenatal ultrasounds and yet we have these babies born all the time that their lesions were not picked up before birth. And that's not just here, that's nationwide."
After birth, cases such as ventricular septal defects and atrial septal defects are detected by murmurs. Another congenital heart defect, called Tetralogy of Fallot, can be detected instead by appearance: "You have a blue baby," Carver said. "When we see a blue baby, we have to rule out if they have sick lungs or a sick heart."
The incidence of congenital heart defects cases, as well as the exact cause, continue to plague the medical community. In compiling data, Muccatira said that studies look at five-year periods to gain an average number. As for the cause, that is another mystery.
Carver said that a family history of congenital heart defects also plays a role.
"If you have a first-degree relative -- a brother, sister, mother or father -- the chances are greater," Carver said. "We're seeing more babies born through assistive reproductive technology" -- such as the use of fertility clinics to conceive -- "and for some unknown reason, that puts them at increased risk for congenital heart disease."
Prevention
Genetics aside, studies have demonstrated several important steps women can take to help prevent congenital heart defects in newborns, according to the N.D. Department of Health, adding that women who are pregnant or may become pregnant should:
+ Avoid all alcohol and illegal or recreational drugs.
+ Avoid exposure to smoke, chemicals and toxins both at work and at home.
"Smoking in the first trimester can increase the risk for heart disease, so that's certainly preventable," Carver said.
+ Take a folic acid supplement Billings recommends 400 micrograms a day and check with their health care provider to confirm that they are getting adequate amounts of all the essential nutrients.
+ See a physician prior to pregnancy, especially if there are medical conditions which require medications, any known metabolic conditions including diabetes, obesity, phenylketonuria, or a family history of congenital heart defects.
"Mothers who are obese or have diabetes during their pregnancy have a higher risk for having a child with heart disease," Carver added. "If we can control their weight and control their blood sugars, they can decrease their risk."
+ Receive regular medical checkups and educate themselves about their family history and potential genetic risks.
The Department of Health also offers support to families with a child born with congenital heart defects. The Cardiac Care for Children Program covers examinations and routine tests to support cardiac assessments performed by pediatric cardiologists providing care in North Dakota, Muccatira said. For more information, he can be contacted at 328-4963 or dmuccatira@nd.gov.
"People shouldn't be scared about these things," Muccatira said. "With technology, the extension of life is much higher for people with congenital heart defects. Many kids have survived and had longer lives, and that's the wonderful thing about it."