Evidence map›Paper›PMID 40878857›Full record

SynthesisEuropean heart journal2026

First trimester maternal infections and offspring congenital heart defects: a meta-analysis.

Huimin Su, Edie Guo, Mark Woodward, Jian-Rong He, Tim Waterboer, Art Schuermans, Alexander Van De Bruaene, Els Troost, Pieter De Meester, Karl Morten and 5 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Seroprevalence ofPublic health challenges · 2026
    Article
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Huimin SuDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0009-0004-0639-9507
Edie GuoNuffield Department of Women's and Reproductive Health, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.ORCID 0000-0001-6930-3876
Mark WoodwardThe George Institute for Global Health, Imperial College London, London, UK.ORCID 0000-0001-9800-5296
Jian-Rong HeDivision of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China.ORCID 0000-0003-3837-5126
Tim WaterboerInfections and Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.ORCID 0000-0002-0616-6963
Art SchuermansDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0000-0001-8146-9692
Alexander Van De BruaeneDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0000-0002-0469-8640
Els TroostDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0000-0001-7920-8661
Pieter De MeesterDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0000-0002-3865-0506
Karl MortenNuffield Department of Women's and Reproductive Health, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.ORCID 0000-0001-6926-6550
Terence DwyerMurdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.ORCID 0000-0002-2091-7663
Christina ChambersDepartment of Pediatrics, University of California San Diego, San Diego, CA, USA.ORCID 0000-0003-4675-7722
Kazem RahimiNuffield Department of Women's and Reproductive Health, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.ORCID 0000-0002-4807-4610
Werner BudtsDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0000-0001-5850-5413
Nathalie ConradDepartment of Cardiovascular Sciences, KU Leuven, Campus Gasthuisberg, Herestraat 49 Leuven 3000, Belgium.ORCID 0000-0001-5027-5481

Funding

KU Leuventhe China Scholarship Councilthe Research Foundation FlandersWellcome Trust 318034
6 · The paper itself

Abstract

BACKGROUND AND

aimsMaternal infections have been proposed to play a role in the development of congenital heart defects (CHD). This study aims to synthesize contemporary evidence on the association between first-trimester maternal infection and risk of offspring CHD.

methodsThis systematic review and meta-analysis (PROSPERO number: CRD42024523638) used Embase, PubMed, Web of Science, Scopus, and the Cochrane Library to identify studies investigating first-trimester maternal infection and offspring CHD, published up until 30 September 2024. Human studies with a minimum of 50 cases were eligible. Inverse variance weighted random-effects models were conducted to pool estimates and stratify associations by infection type and heart defect type.

resultsA total of 30 studies (24 case-control, 3 cohort, and 3 cross-sectional studies) with 1 732 295 pregnancies were identified. Studies assessed maternal infectious status through self-reported questionnaires (n = 20, 66.7%), laboratory testing (n = 7, 23.3%) or medical records (n = 3, 10.0%). Overall, any first-trimester maternal infection was associated with higher risk of CHD in offspring, with a pooled odds ratio (OR) and 95% confidence interval (CI) of 1.63 (1.41, 1.88). Among specific types of infection, rubella virus, coxsackievirus, respiratory infections, and influenza presented higher risks of offspring CHD, with ORs (95% CI) of 2.78 (2.08, 3.72), 1.57 (1.12, 2.19), 1.57 (1.25, 1.96), and 1.50 (1.20, 1.87), respectively. Studies that reported associations by individual subtype of CHD relied on a comparatively modest number of cases. Pooled ORs for exposure to any first-trimester infection were 1.59 (1.16, 2.20) for ventricular septal defects, 1.55 (1.21, 1.99) for atrioventricular septal defects, and not statistically significant for other subtypes.

conclusionsFirst-trimester maternal infections are associated with increased risk of offspring CHD and appear to extend beyond infections commonly tested for during routine pregnancy screening. Larger-scale studies are warranted to confirm these findings using laboratory antibody testing and explore underlying mechanisms.

Indexed as

Heart Defects, CongenitalPregnancy Complications, InfectiousFemaleHumansPregnancyPregnancy Trimester, FirstRisk FactorsCongenital heart defectsEpidemiologyMaternal infectionsSystematic review

Identifiers

PMID40878857
PMCPMC7618761

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.