الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Congenital heart disease is one of the major problems encountered in the pediatric age. The impact of this birth defect in terms of disability, hardly requires emphasis. Knowledge of the epidemiology of CRD will provide a more profound information and wil thus contribute to a more effective planning of preventive medical care of these children and if necessary their families. The present study was carried out with the aim of studying the nature of CHD and its relation to various epidemiological factors The present study ,-;as designed as a case control study. . All cases diagnosed as CRD and attending El Shatby , El RamI and El Anfoushy pediatric hospitals, were investigted , throughout the period from the first of September 1983 to the end of August 1984. Those amounted to 176 cases of CRD. For each case a control matched for age and sex was chosen taking into consideration being free from congenital anomalies / or cardiac diseases. The mother of the child was interviewed to collect the necessary information. For CRD cases, buccal smear examination for sex chromatin and karyo type analysis for suspected cases were done to detect chromosomal aberration~. A permanent record of dermatoglyphic patterns of both hands of cases and controls WaS obtained. The study showed the following main results: 1 . The commonest type found was VSD (43.75) follo,.,red by F4 (23.86) and PS (11.36 ). . 2 . The highest mean age found was that of cases with AS(7.83+ 2.32) followed by PS(7.80t1.82) and VSD ( 5.27 ~ 2.93 ). 3 . There is no 8ignifica~t difference between the proportion of males and of females among different types of CHD . The mean ag~ of males compared to that of the females in different types of CED ,is not statistioally significant 4 . Using Raldane and Smith Analysis of birth order, ASD ,PS, and F4 appear to affect earlier siblings. 5 . Prematures have eleven times (cOR=11.667) the risk to have concomitant CHD . 6 . ~abies born to fathers aged 40. years or more h~e significantly 2.141 times the risk to have CED. 7 . No significant difference bet~een cases and controls was found concerning . month of birth , parental level of education and occupation. 8 . ~abies born to consanguineous parents have significantly 2.032 times the risk to have CED . 9 . Babies are at risk to h~e CHD if they were born to mothers who h~ : five or more pregnanancies,pr~m~ infertility just before the index pregnancy , pill diagnosis of the index pregnancy , use of contraceptives during pregnancy and diabetes mellitus . 10 . Using stratified analysis technique, certain risk factors are not affected when controlling for other variable& Among them are : pill diagnosis of pregnancy , primary infertility, contraception during pregnancy and fathers age. 11 . Chromosomal aberration ( trisomy 21 ) was evident in 1.7 of CHD cases. 12 . Certain configurations are evident in dermatoglyphic patterns of CIID cases compared to controls. Among them are : decrease in ulnar loop in finger tips , excess of hypothenar patterns and wider ”atd” angle. The following are the main recommendations: 1 . Limitation of use of sex hormones in diagnosis of pregnancy. 2 . Health education for mothers concerning proper use of contraceptives. 3 . Premarital counselling is advised especially for consanguineous couples. ij . Limitation of drug adminstration during pregnancy to the highly necessry drugs.