Table 1

Common environmental exposures/teratogens and associated CHDs.

Teratogen

Commonly Associated CHDs:

Assisted reproductive technology

  • Mild CHD more common than severe:

    • Ventricular septal defects

    • Ventricular free wall thickening

    • Pericardial effusion

    • Tricuspid regurgitation

    • Displaced apex

Maternal diabetes

  • Ventricular septal defects

  • Atrioventricular septal defects

  • Tetralogy of Fallot

  • Transposition of the great arteries

  • Truncus arteriosus

  • Hypoplastic left heart

  • Patent ductus arteriosus

Maternal lupus

  • Fetal heart block

Maternal phenylketonuria (PKU)

  • Ventricular septal defects

  • Tetralogy of Fallot

  • Patent ductus arteriosus

  • Hypoplastic left heart syndrome

Rubella

  • Patent ductus arteriosus

  • Ventricular septal defects

  • Atrial septal defects

  • Peripheral pulmonary stenosis

Alcohol

  • Ventricular septal defects

  • Atrial septal defects

  • Patent ductus arteriosus

Lithium

  • Ebstein's anomaly (10%)

  • Tricuspid atresia

Hyperthermia

  • Conotruncal and obstructive defects

Antiepileptics

  • Ventricular septal defects

  • Atrial septal defects

  • tetralogy of Fallot

  • Pulmonary valve atresia

  • Hypoplastic right heart

Vitamin A

  • Pulmonary stenosis and outflow tract abnormalities

Paroxetine

  • Ventricular septal defects

  • Atrial septal defects

  • Outflow tract obstructions

NSAIDs, such as Ibuprofen

  • Transposition of the great arteries

  • Ventricular septal defects

  • Bicuspid aortic valve

  • Sources for table: Lynch et al. and Patil et al.152,153