How a pregnant woman can cause heart defects in her baby

From conception, pregnancy, birth, and development, the baby’s greatest influence is their mother. A mother’s well-being and lifestyle go a long way in determining if the baby will be born with congenital heart disease or not. According to March of Dimes, a US-based health organisation that focuses on women's and children’s health, if the mother is in good health, the chances of the baby being born with a healthy heart are high. However, if the mother has a health condition, there is an increased risk of having a baby with congenital heart disease. Some of the health conditions that will increase this risk include:

Lupus

Lupus is an autoimmune disease in which the body’s immune system becomes hyperactive and attacks normal and healthy tissue. According to Dr. Joe Craft, a professor of rheumatology and immunobiology, apart from kidney damage, the disease also affects joints, blood, lungs, heart, and skin. “Kidneys are particularly vulnerable to a condition known as lupus nephritis, in which a patient’s own T cells infiltrate kidney tissue and trigger a decrease in oxygen. This leads to tissue damage and potentially last-stage kidney disease,” said Dr. Craft. In Kenya, about 200,000 people are estimated to suffer from Lupus. Lupus – also known as Systemic Lupus Erythematosus (SLE) – is one of the most cost-intensive diseases. Every month, the disease can consume over Sh. 200,000. This includes drugs, blood tests, dialysis, and hospital admissions.

Maternal phenylketonuria 

This condition is also known as PKU. With this condition, the mother’s body is unable to break down an amino acid called phenylalanine. “Amino acids build protein in your body. Without treatment, phenylalanine builds up in the blood and causes health problems. However, the majority of pregnant women with PKU can have healthy babies if they follow a special meal plan that’s low in phenylalanine,” March of Dimes says in an analysis of the relationship between pregnancies and congenital heart diseases.

Obesity

If you’re obese, you have an excess amount of body fat, and your body mass index (BMI) is 30 or higher. The Centre for Disease Control cautions that childhood obesity is now a direct risk factor for heart diseases later in life. In addition, young women with obesity are now at an increased rate of developing heart diseases themselves. This increased risk is attributed to the sex hormone progesterone. This hormone is responsible for boosting and sustaining fertility among women. “Progesterone enables a high level of a receptor for the aldosterone hormone, which can damage the vascular system in the cells that line the interior surface of blood vessels (known as endothelial cells),” said Dr. Eric Belin de Chantemele from Augusta University’s Vascular Biology Centre and Department of Medicine, in a report on the link between obesity and heart diseases in premenopausal women. The aldosterone hormone plays a central role in the regulation of blood pressure by increasing the amount of salt – sodium – that is reabsorbed into the bloodstream while increasing the amount of potassium that is excreted in the urine. Also, young, obese women with cardiovascular problems often have other compounding factors such as diabetes and smoking addictions. In Kenya, obesity is the fastest rising health problem for premenopausal women. The Kenya Demographic and Health Survey (KDHS) conducted in 2009 indicated that the national prevalence of overweight and obesity for women aged between 15 years and 49 years was 23 percent. The KDHS 2014 survey showed that 47.1 percent of women in central Kenya were either obese or overweight with a body mass index (BMI) of 25.3kg/m2. By 2018, the Ministry of Health and the World Health Organization (WHO) put the number of women in Kenya who are obese at 13.7 percent.

Rubella

This infection causes mild flu-like symptoms and a rash on the skin. According to March of Dimes, having rubella during pregnancy may increase your baby’s risk for CHD.

Medications

Taking certain medicines may increase your baby’s risk of having congenital heart disease. These medicines are strictly supposed to be taken with the express recommendation of a qualified medical professional and within the required dosage. According to March of Dimes’ heart organisation, some of the medications you should consult your physician before taking include:

• ACE inhibitors: This drug is used to treat high blood pressure or hypertension. High blood pressure is the condition in which the long-term force of the blood against your artery walls is high enough that it may end up causing heart disease.
• Lithium: Also known as lithium carbonate and lithium citrate, this drug is authorised by FDA as a prescription drug for bipolar disorder.
• Statins: These are drugs that work to lower your cholesterol, which can increase your risk of heart disease if untamed. Statins are also known to lower the risk of stroke and heart disease.
• Isotretinoin: This drug is a form of vitamin A that is used to treat severe nodular acne.
• Thalidomide: This drug is used to treat certain skin conditions, certain types of cancer, and skin conditions and complications.