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Unlabelled: The objective of this study was to determine the association between parental cigarette smoking and the risk of congenital heart septal defects in Kaunas infant population in 1995-2005., Material and Methods: An epidemiological case-control study was conducted. The study comprised 261 newborns with congenital heart septal defects (cases) and 1122 randomly selected newborns without any defects (controls), born in Kaunas city during 1995-2005. Information on potential risk factors of newborns' health was collected through an interview with parents using standardized questionnaires. Multivariate logistic regression analysis was used to assess the association between parental smoking and septal defects while controlling for possible confounders., Results: According to the validated registry, 371 newborns with congenital heart malformations were born in Kaunas city during 1995-2005; 70.3% of cases had ventricular and/or atrial septal defects. After adjustment for possible confounding factors - maternal education, social status, marital status - a statistically significant relationship was observed between parental smoking and congenital heart septal defects. Parental, maternal, and paternal smoking was significantly associated with a 2.27-fold (adjusted OR=2.27; 95% CI, 1.49-3.46), 2.2-fold (adjusted OR=2.20; 95% CI, 1.01-4.79), and 1.45-fold (adjusted OR=1.45; 95% CI, 1.03-2.03) increased risk of defects if compared with nonsmoking parents., Conclusions: According to the results of our study, parental smoking was significantly associated with an increased risk of congenital heart septal defects in infants.

Unlabelled: The objective of study was to estimate the importance of maternal socioeconomic and lifestyle factors during pregnancy in the risk of congenital heart defects in Kaunas infant population in 1999-2005., Material and Methods: An epidemiological case-control study was conducted. The study comprised 187 newborns with congenital heart defects (cases) and 643 randomly selected newborns without any defects (controls), born in Kaunas city during 1999-2005. Modern epidemiological methods were used for data analysis. A multivariate logistic regression was used to determine adjusted risk factors of congenital heart defects., Results: The logistic multivariate regression analysis showed that low and moderate maternal education significantly increased the risk of congenital heart defects (primary or basic [OR=3.43; 95% CI, 1.54-7.64] and secondary [OR=1.56; 95% CI, 1.00-2.45] vs advanced vocational or higher education). The housewives and workers had a higher risk of delivering a newborn with congenital heart defects than the office workers (OR=2.34; 95% CI, 1.34-4.10 and OR=1.28; 95% CI, 0.79-2.07, respectively). Maternal smoking during pregnancy tended to increase the risk of congenital heart defects by 48% (OR=1.48; 95% CI, 0.82-2.67)., Conclusions: According to our study results, unfavorable maternal socioeconomic factors and smoking during pregnancy increased the risk of congenital heart defects.

The aim of the article is to review the published scientific literature and epidemiological studies about the effect of selected environmental risk factors on congenital heart defects in infants. According to recent reports, the prevalence of congenital heart defects is around 1% of live births. Congenital heart malformations are the leading cause of infant mortality. Unfortunately, the majority of the causes of heart defects remain unknown. These malformations are caused by interaction of genetic and environmental factors. The article reviews selected environmental risk factors: maternal illnesses and conditions associated with metabolic disorder (maternal diabetes, obesity, phenylketonuria), maternal lifestyle factors (alcohol use, smoking), which may increase the risk of congenital heart defects.

Unlabelled: The objective of this study was to determinate the incidence and diagnostics of congenital heart defects in Kaunas infant population in 1999-2005 and to compare the data obtained with the data of years 1995-1998., Subject and Methods: The study population comprised all newborns born in Kaunas city during 1999-2005. Congenital heart defects were registered based on clinical diagnosis after its verification using the data from consulting centers and pediatric outpatient departments. To assess the incidence of congenital heart malformations in newborn population, we conducted a validated newborn register based on maternal residential district. Modern epidemiological methods were used for data analysis., Results: In 1999-2005, there were 24 069 live births in Kaunas: 2231 newborns were born with congenital anomalies, 198 had congenital heart malformations. The incidence of congenital heart defects was 8.2 per 1000 live newborns. The majority of congenital heart malformations were diagnosed in delivery units (93.94%). We have analyzed the relationship between birth weight and gestational age of newborns with congenital heart malformations. Newborns with low birth weight were at significantly higher risk of congenital heart malformation than newborns with normal birth weight (OR=3.52, 95% CI, 2.25-5.47). Our data also showed that newborns born before 32 weeks of gestation had a 5-fold increased risk of congenital heart malformation (OR=5.20; 95% CI, 2.50-10.84) and infants born before 37 weeks of gestation had a 4-fold increased risk (OR=4.08; 95% CI, 2.68-6.19) compared with newborns born after 37 weeks of gestation., Conclusions: This study shows that incidence of congenital heart anomalies in Kaunas newborn population was 8.2 cases per 1000 live newborns in 1999-2005. It was determined that during 1999-2005, the number of above-mentioned anomalies diagnosed in delivery units increased by 23%.

Objective: We examined the prevalence and risk factors of heart failure among 25- to 64-year-old men treated in hospitals for first-time myocardial infarction., Material and Methods: A nested case-control study included 448 men with first-time myocardial infarction, treated in Kaunas hospitals during 1997-2000. Questionnaires elicited information on demographic characteristics and health problems of respondents, psychological stress, and other risk factors. A multivariate logistic regression was used to determine adjusted risk factors for heart failure., Results: Adjustment for age, education, smoking, blood pressure, body mass index, psychological stress, and impaired glucose tolerance showed that main risk factors for development of chronicle heart failure among myocardial infarction patients were impaired glucose tolerance (OR=2.32; 95% CI 1.38-3.88), hypertension (OR=1.51; 95% CI 1.01-2.25), and overweight (OR=1.60; 95% CI 1.00-2.57). Psychological stress and smoking also tended to increase the risk for heart failure. Acute heart failure was significantly associated with impaired glucose tolerance (OR=3.15; 95% CI 1.27-7.84)., Conclusion: Risk factors for heart failure were similar to those for coronary heart disease, and their combinations significantly increased the heart failure risk.

Unlabelled: The aim of the study was to assess the relationships between environmental risk factors and the risk of congenital heart malformations., Methods and Materials: An epidemiological case-control study was conducted. We investigated the effect of 43 potential risk factors for congenital heart malformations and calculated their crude and adjusted odds ratios., Results: The analysis revealed that maternal age at delivery (< 19 or > or = 35 years), marital status, chronic diseases, reproductive history, maternal and paternal smoking, occupational and residential hazards were associated with increased risk of congenital heart malformations. Residential exposure to ambient formaldehyde (>2.42 microg/m3) tended to increase the risk of congenital heart malformations by 24% (OR=1.24; 95% CI 0.81-2.07)., Conclusion: Stratified analysis of effects of exposure to occupational and residential hazards together showed that the risk of congenital heart malformations has increased significantly.

The aim of the study was to assess the effect of exposure to ambient lead and other environmental factors on first myocardial infarction incidence. Epidemiological case-control study comprised 579 male cases (25-64 year old) of myocardial infarction, treated in Kaunas hospitals and 1777 controls of the same age group without ischemic heart disease. Myocardial infarction incidence in the area of low exposure to lead was 2.34 per 1000, while in the high exposure area it was 2.61 per 1000. We determined the distribution of potential myocardial infarction risk factors among cases and controls and calculated corresponding crude odds ratios. Variables considered for inclusion in multivariate logistic regression model were those with higher prevalence among cases and values of odds ratios greater than 1.5. The analysis revealed that smoking, arterial hypertension and stress significantly increased the risk of first myocardial infarction among 25-64 year old men. Occupational exposure to chemical substances increased myocardial infarction risk by 26%, while residential exposure to ambient lead concentrations, exceeding 0.225 microg/m (3), tended to increase myocardial infarction risk by 12% (95% PI 0.94-1.34).

A literature review discusses the effect of selected environmental factors on women reproductive system, fetal development and growth. According to recent reports, 2-3% of newborns have congenital malformations. These malformations are caused by interaction of genetic and environmental factors. Exposure of paternal or maternal organisms to environmental hazards may damage germ cells or interfere fetal development, resulting in malformation of various organ systems. Since environmental hazards exposures are complex, it is difficult to establish the primary effect of single factor. Factors, that are known to increase the risk of congenital malformations, preterm delivery or spontaneous abortion, are classified into five groups--psychological, social, biological, physical and chemical factors. The governments of most counties recognize the effect of hazardous environmental factors on public health as global problem. World Health Organization encourages researches, aimed at evaluation of various environmental factors impact on health of pregnant women and their offsprings.

We examined the association between social status, assessed by education and occupational categories and risk of myocardial infarction. We conducted a case-control study among 35-64 year-old women of Kaunas. Cases were 191 women with first myocardial infarction treated in hospitals in 1997-2000, and controls were 482 women in the same age group, randomly selected, without ischemic heart disease. We used multiple logistic regression to estimate the adjusted odds ratios of developing myocardial infarction in relation to social status and psychological stress. The study results indicated that stress, arterial hypertension, smoking, overweight and low education increased the risk of first myocardial infarction among 35-64 years old women. Managers and service, market sales workers had about twice higher risk for myocardial infarction than associate professionals (OR = 2.64; 95% CI 1.17-6.62 and OR = 2.18; 95% CI 1.03-4.63 correspondingly).

This study presents the results of analysis of congenital heart malformations (CHM) prevalence, lethality and mortality of newborns with CHM in 1995-1998 in Kaunas city. According to official data, 131 CHM cases were registered in delivery hospitals using statistical forms 066. We conducted a validated registry in all children outpatient hospitals and in Neonatology division of Kaunas University of Medicine. We registered additional 53 CHM cases, which made up an increase by 28.8 percent. The prevalence of CHM increased from 7.5 to 10.6 per 1000 livebirths. Mortality of infants, born with CHM was 2.36 per 1000 livebirths, while lethality was 22.3 percent per year.