Intake of sucrose-sweetened soft beverages during pregnancy and risk of congenital heart defects (CHD) in offspring: a Norwegian pregnancy cohort study.

Studies report increased risk of congenital heart defects (CHD) in the offspring of mothers with diabetes, where high blood glucose levels might confer the risk. We explored the association between intake of sucrose-sweetened soft beverages during pregnancy and risk of CHD. Prospective cohort data with 88,514 pregnant women participating in the Norwegian Mother and Child Cohort Study was linked with information on infant CHD diagnoses from national health registers and the Cardiovascular Diseases in Norway Project. Risk ratios were estimated by fitting generalized linear models and generalized additive models. The prevalence of children with CHD was 12/1000 in this cohort (1049/88,514). Among these, 201 had severe and 848 had non-severe CHD (patent ductus arteriosus; valvular pulmonary stenosis; ventricular septal defect; atrial septal defect). Only non-severe CHD was associated with sucrose-sweetened soft beverages. The adjusted risk ratios (aRR) for non-severe CHD was 1.30 (95% CI 1.07-1.58) for women who consumed 25-70 ml/day and 1.27 (95% CI 1.06-1.52) for women who consumed ≥ 70 ml/day when compared to those drinking ≤ 25 ml/day. Dose-response analyses revealed an association between the risk of non-severe CHD and the increasing exposure to sucrose-sweetened soft beverages, especially for septal defects with aRR = 1.26 (95% CI 1.07-1.47) per tenfold increase in daily intake dose. The findings persisted after adjustment for maternal diabetes or after excluding mothers with diabetes (n = 19). Fruit juices, cordial beverages and artificial sweeteners showed no associations with CHD. The findings suggest that sucrose-sweetened soft beverages may affect the CHD risk in offspring.

Mothers of infants with congenital heart defects: well-being from pregnancy through the child's first six months.

PURPOSE: This study compared the well-being among mothers of children with congenital heart defects (CHD) with mothers of children without CHD (controls), at pregnancy and at 6 months postpartum. METHODS: We linked prospective data from the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health, with a nationwide medical CHD registry. In the MoBa cohort of 61,456 mothers, we identified 212 mothers of infants with mild (n = 92), moderate (n = 50), or severe CHD (n = 70). Subjective well-being was operationalized by means of maternal life satisfaction, joy, and anger at the 30th week of gestation and at 6 months postpartum. RESULTS: Subjective well-being in mothers of children with CHD remained unchanged and similar to that of controls on satisfaction with life (P = 0.120) and feelings of joy (P = 0.065). However, at child age 6 months, mothers of infants with severe CHD reported slightly elevated feelings of anger compared with controls (P = 0.006). CONCLUSIONS: Joy and life satisfaction remained intact among mothers of children with CHD. Yet, elevated feelings of anger in mothers of children with the most severe CHD suggest that they may experience more frustration.

Long-term symptoms of depression and anxiety in mothers of infants with congenital heart defects.

OBJECTIVE: To examine the relationship between the severity of infants' congenital heart defects (CHD) and their mothers' symptoms of depression and anxiety from pregnancy to 18 months postpartum. METHODS: Mothers of infants with mild, moderate, or severe CHD (n=162) and mothers (n=44,400) within the Norwegian Mother and Child Cohort Study were assessed with an eight-item short version (SCL-8) of the Hopkins Symptom Checklist-25 at the 30th week of gestation and at 6 and 18 months postpartum. RESULTS: Only the postpartum mental health trajectory of mothers of infants with severe CHD deviated from the mental health trajectory of the cohort at 6 and 18 months postpartum, showing significantly elevated levels of depression and anxiety symptoms. CONCLUSIONS: The results elucidate the relationship between infants' CHD severity and maternal symptoms of depression and anxiety, possibly identifying a specifically vulnerable patient dyad in need of postoperative interventions.

Emotional reactivity in infants with congenital heart defects and maternal symptoms of postnatal depression.

The object of this study was to examine the role of emotional reactivity in infants with congenital heart defects (CHD) in relation to their mothers' symptoms of postnatal depression. The study population was drawn from the Norwegian country-wide CHD registry from the Department of Pediatric Cardiology at Oslo University Hospital and the Norwegian Mother and Child Cohort Study. Mother-infant dyads with mild/moderate or severe CHD (n=242) were assessed with a 6-item short version (EPDS-6) of the Edinburgh Postnatal Depression Scale and the Infant Characteristic Questionnaire's fussy/difficult subscale (ICQ-D/F-7) at 6 months postpartum. When adjusting for infant emotional reactivity, mothers of infants with severe CHD showed significantly elevated symptoms of postnatal depression 6 months postpartum (odds ratio=2.22) compared to the mothers of infants with mild/moderate CHD. The results identify severe CHD in infants as a predictor of heightened symptoms of postnatal depression in mothers, independent of the infant's emotional reactivity. Although a causal direction underlying the association could not be determined, the possible, negative reciprocal relationships between severe CHD in infants, high levels of emotional reactivity in infants, and symptoms of maternal postnatal depression are considered.