What Can Be Done to Reduce Risk
Not all congenital heart defects can be prevented, but several evidence-based steps may reduce risk. The most well-established modifiable factors include: controlling pre-gestational diabetes as tightly as possible before and during pregnancy, since poorly controlled maternal diabetes significantly increases the risk of several cardiac defects; avoiding smoking, alcohol, and recreational drugs during pregnancy; ensuring rubella immunization is current before becoming pregnant (rubella infection in the first trimester is a known teratogen); reviewing all prescription and over-the-counter medications with a physician before conception, since several commonly used drugs — including isotretinoin, some anticonvulsants, lithium, and certain NSAIDs — are associated with increased cardiac risk; and taking folic acid supplementation as recommended, which reduces the risk of neural tube defects and may confer some protection against cardiac defects.
Preconception Planning for High-Risk Individuals
Women with pre-existing congenital or structural heart disease, a family history of CHD, or a prior child born with a heart defect are at higher risk and should consider pre-pregnancy counseling before attempting conception. A preconception consultation with an ACHD cardiologist and, in some cases, a maternal-fetal medicine specialist and genetic counselor can assess maternal cardiac risk, review medication safety, discuss the likelihood of fetal CHD based on family history, arrange fetal echocardiography during pregnancy, and develop a delivery and postpartum care plan. Congenital Heart Compass Medical PLLC provides preconception cardiac counseling and cardio-obstetrics telemedicine care for women across New York State.
Reviewed by Dr. Pradeepkumar Charla, MD, MBA, FAAP, FACC
Pediatric & Adult Congenital Cardiologist — Congenital Heart Compass Medical PLLC
Last reviewed:
Medical disclaimer: This content is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment. Always consult a qualified cardiologist for decisions about your congenital heart disease care.