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Mothers' lifestyles can affect
their babies' risk of heart defects

Future parents can make lifestyle choices to reduce the risk that their child will be born with a congenital heart defect, according to a recent American Heart Association (AHA) review, led by lead author Kathy Jenkins, MD, MPH, senior associate in Cardiology at Children's Hospital Boston.

The study recommends that prospective mothers follow these five recommendations to follow from three months before conception through pregnancy:

• Take a daily mult-vitamin containing 400 micrograms of folic acid.
• Review medication use with your obstetrician, including over-the-counter drugs.
• Avoid contact with people who have the flu or a fever-related illness.
• Find out whether you have phenylketonuria (PKU) or diabetes so you can be treated. Make sure you've been vaccinated against rubella (German or three-day measles).
• Avoid exposure to organic solvents.

During the past 10 years, researchers have made major breakthroughs in understanding the genetic causes of congenital heart defects. These guidelines, however, emerged from a review of the existing literature on non-inherited factors that could affect the fetal heart.

"This is a new way of thinking and a positive vision of how prospective mothers can influence and protect a child from being born with a heart defect," says Dr. Jenkins, who is also director of Children's Program for Patient Safety and Quality.

Her research, which highlights parental accountability, has changed the way she discusses heart defects with parents. "The major goal of conversations was once to make mothers not feel guilty," she says. "As reassuring as that may be, it's not helpful, because some choices or exposures may have made a difference." While these discussions can be difficult, Dr. Jenkins has found that parents of children with congenital heart defects are starved for information. "They want to make sure that their next baby—or their sister's child, their daughter's daughter—is born healthy." Dr. Jenkins' recommendations provide some important strategies to make that happen.

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