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Open Access Research article

Congenital heart disease in men – birth characteristics and reproduction: a national cohort study

Kristina Kernell12, Gunilla Sydsjö12, Marie Bladh12, Niels Erik Nielsen34 and Ann Josefsson125*

Author Affiliations

1 Department of Obstetrics and Gynaecology, Linköping University, Linköping, Sweden

2 Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

3 Department of Cardiology, Linköping University, Linköping, Sweden

4 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

5 Department of Obstetrics and Gynaecology, University Hospital, SE_581 85 Linköping, Sweden

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BMC Pregnancy and Childbirth 2014, 14:187  doi:10.1186/1471-2393-14-187

Published: 2 June 2014

Abstract

Background

Women with congenital heart disease (CHD) are more often born preterm or small-for-gestational age and with a caesarean section. This pattern together with an increased risk of congenital anomalies seems to be repeated in the next generation. Information on the effect of paternal CHD on their offspring is sparse. In this study we investigated if men with CHD differ from those who do not have CHD with respect to characteristics related to their own births, their reproductive patterns and the neonatal outcomes of their children.

Methods

In this national cohort study data were derived from Swedish population-based registries. The population consists of all men born in 1973-1983 who were alive and living in Sweden at 13 years of age (n = 522 216). The index group is men with CHD (n = 2689). Men diagnosed with CHD were compared with men without CHD. The CHD were also divided into two groups, complex and simple CHD and comparisons between the groups were made.

Results

Men with CHD are more likely to have been born preterm (p < 0.001), small-for gestational-age (p < 0.001) or large-for-gestational-age (p < 0.001) than men without CHD. They are also more likely to have been the result of a twin pregnancy (p < 0.001) and to have been delivered by caesarean section (p < 0.001). Men with CHD have a decreased likelihood to become fathers compared to non-CHD men and in this study their offspring do not have a higher incidence of CHD than offspring to non-CHD fathers. The neonatal outcomes of children of men with CHD do not differ from the outcomes of children of non-CHD men.

Conclusions

Men with CHD were more often born with non-optimal characteristics compared to men without the condition. However, the increased risk does not repeat itself in the next generation. This knowledge can lead to improved preconception counselling for couples in which the father has a CHD.

Keywords:
Congenital heart disease; Population register; Preconception care; Reproduction