ABSTRACT
OBJECTIVE: Congenital anomalies are the leading cause of infant death, with congenital heart (CHD) defects the most common type. The study objective was to evaluate the incidence of fetal CHD in a tertiary care medical center's obstetric population in West Virginia and map areas of possible environmental exposure. METHODS: This was an observational study of patients with positive ultrasound screen for CHD from 1/1/2007-8/31/2016. An Optimized Hot Spot analysis and Ripley's K- Function was constructed to understand the effect of CHD in relation to proximity to chemical and coal extraction sites. RESULTS: Of the 16,871 obstetric pregnancies, 206 (1.2%) had fetal CHD with ventriculoseptal defects the most common (88; 42.7%). The majority of cases of CHD followed the industrial watershed of the Kanawha River in West Virginia. Direct point source exposure suggests a relationship in cases of CHD within Kanawha River and surrounding areas. The observed K was significantly above the expected K across all 10 distance bands. The fourth distance band exhibited the larger difference at (37914), between the expected verses the observed K function. CONCLUSION: Through spatial analysis, there appears to be a direct point source exposure for observed cases of f CHD along the industrial watershed of Kanawha County, West Virginia.
