New heart guidelines aim to stop newborn defects

The American Heart Association released new recommendations on Tuesday to help women reduce the risk of giving birth to children with heart defects.

The four key recommendations boil down to: talk to your doctor, take a daily dose of folic acid, avoid people with the flu and review all medication use with your doctor even if it is over-the-counter.

The guidelines can be applied even before a woman becomes pregnant, the association said in a scientific statement.

"These are specific recommendations aimed at people who want to reduce their risk of having a baby with a heart defect," said Dr. Kathy Jenkins, senior associate in cardiology at Children's Hospital Boston.
"They come from existing literature but we have put it all together and where there is a sufficient body of evidence to support a recommendation we have made one ... So they are new recommendations," she said in a telephone interview.

The first recommendation is that prospective mothers see their doctor and be checked for diabetes, rubella (German or three-day measles) and influenza.

"A second recommendation is for women to take a daily multivitamin containing 400 micrograms (mcg) of folic acid or a folic acid supplement," said Jenkins, who is also associate professor of pediatrics at Harvard Medical School.

Folic acid can protect against heart defects as well as its better-known role in protecting against spinal cord defects and women should take it before conception. Many foods are also fortified with folic acid.

Reviewing medication use is also regarded as crucial, the Heart Association said.

Finally, the association said prospective mothers should avoid contact with people who have the flu or other illnesses that can cause fevers.

"Any fever-related illness during the first trimester of pregnancy may carry a two-fold higher risk of offspring with heart defects," the statement said.

"Congenital heart defects ... are structural problems with the heart present at birth. They result when a mishap occurs during heart development soon after conception and often before the woman is aware she is pregnant," it said.

The American Heart Association estimates that out of 1,000 births, nine babies will have some form of congenital heart disorder. Congential cardiovascular defects are the most common birth defects.