American Heart Month: Learn the Facts About Heart Defects

By Lori Wolfe, MS, Genetic Counselor & OTIS President

We all know that February brings us Valentine's Day, but did you know it is also American Heart Month? This month, heart symbols are everywhere you look! Recently, a call from a friend of mine made me stop thinking about candy and red paper hearts, and start thinking about beating hearts. My friend is very excited to be experiencing her first pregnancy and I have been sharing in her joy. Last week, she called in tears to tell me that her 20 week sonogram showed that her baby has a heart defect. This news came as a shock to Melissa and her husband Mark as there is no family history of heart defects on either side of the family. As Melissa knows that I am a genetic counselor and work with pregnant women, her first question to me was, why did this happen to our baby? So I began to share what I know with Melissa, which I will also share here with you.

Heart defects in babies are more common than you may think. In fact, congenital heart defects (CHD) are the most common birth defects that occur in babies. The good news is that, these days, almost all babies born with CHD survive into adulthood, and many live a normal lifespan.

So back to Melissa's question, what causes heart defects and why is her baby affected? Sometimes there is a genetic link, so it is important to know if you have a family history of heart defects. Many times, we don't know why the baby has a heart defect. Birth defects happen randomly in 3 to 5% of all babies born. But we do know that about 10% of all birth defects, in general, are caused by exposure during pregnancy to things called "teratogens." Teratogens refer to any exposure during pregnancy that can harm a baby. The good news is, these kinds of exposures are often preventable, which means that the resulting birth defects are potentially preventable too.

So what should you be especially aware of regarding your developing baby's heart? We do know that over 80% of all women are exposed to a medication during pregnancy and there are some medications that can increase the chance that a baby will have a heart defect. These medications include:

• Lithium, which is used mainly to treat Bipolar Depression Disorder.
• Isotretinoin, a form of vitamin A that is found in Accutane and is used to treat severe acne.
• Phenobarbital, a medication mainly used to treat seizure disorders.
• Alcohol. Drinking alcohol during pregnancy can also increase the chance that your baby will have a heart defect.

It is always important to receive good prenatal care and avoid alcohol and illicit drugs when you are pregnant. If you are taking a prescription medication, you do need to be sure to talk with your doctor before you stop taking medication such as Lithium or Phenobarbital. Your doctor will help you decide if the benefits to you of taking the medication for your condition outweigh the small risk for a possible birth defect like a heart defect.

For all of the Melissas out there, know that you also have a friend to lean on for answers to your questions about preventing heart defects in the field of healthcare. If you have any questions about exposures during pregnancy or while nursing your baby, please call the Organization of Teratology Information Specialists (OTIS) at (866) 626-6847 or check us out at OTISPregnancy.org.

**Lori Wolfe, MS, is a board-certified genetic counselor and the president of OTIS. She is also the director of OTIS' Texas affiliate, the Texas Teratogen Information Service (TTIS), which she founded in 1991. Visit its website at http://www.ttis.unt.edu/. OTIS is a North American non-profit dedicated to providing accurate evidence-based information about exposures during pregnancy and breastfeeding.**