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The Prevention of Heart Defects in Babies Starts Before Pregnancy

Congenital heart defects, the most common type of birth defect, affect eight out of every 1,000 newborns.1 Congenital heart defects are structural abnormalities of the heart that form during fetal development in the womb. These defects, attributed to inherited and non-inherited risk factors, disrupt the normal flow of blood through the heart causing blood flow to slow down, go in the wrong direction, or become blocked.¹

A new study found that a woman’s lifestyle before and during pregnancy may affect whether her baby is born with a heart defect.2 For example:
  • Therapeutic and non-therapeutic drugs and environmental exposures may increase the risk of congenital heart defects.

  • Women reporting any type of fever-related illness during the first trimester of pregnancy are at a twofold higher risk of delivering a baby with a heart defect.

    Unlike many other congenital abnormalities, congenital heart defects can be corrected; however, prevention remains important. To reduce the risk of congenital heart defects, the American Heart Association recommends that women who wish to become pregnant:

    • Take a multivitamin with 400 micrograms (mcg) of folic acid daily (which also helps prevent neural tube defects).
    • See their doctor to be checked for diabetes, as well as vaccinated and tested for rubella (German or three-day measles) and influenza.
    • Report any medicines they use (even over-the-counter medications) to their doctor.
    • Avoid contact with people who have influenza or other fever causing diseases.2

Cost of Congenital Heart Defects

According to the Centers for Disease Control and Prevention (CDC), infants who are born with a congenital heart defect have the highest average hospital charges, ranging from about $80,814 to $199,597. The average hospital stay for a congenital heart defect is between 15 and 28 days.3

The CDC also notes that some of these conditions may require multiple surgeries later in life that could have long-term economic and psychosocial costs for the child and family.

What Can Employers Do?

  • Require health plans to provide adequate educational materials to beneficiaries about heart defects and the AHA’s recommendations (listed above) BEFORE they become pregnant. This information could be included in worksite wellness materials that focus on safe motherhood, healthy pregnancy, and/or women's health.
  • Consider covering physician-prescribed multi-vitamins containing folic acid under prescription drug plans. Multivitamins are an effective and inexpensive way to prevent heart defects, neural tube defects, and promote healthy pregnancies.
  • Encourage all beneficiaries – particularly those at risk for complications - to be immunized against influenza. Also encourage good hygiene habits like hand washing to prevent the transmission of colds and other diseases.
  • Cover influenza vaccines in all health plans and consider reducing or eliminating copays or coinsurance.
  • Offer influenza vaccines at the worksite.
For more information, please refer to the Purchaser’s Guide for Clinical Preventive Services

Additional resources:

Folic Acid Supplementation (Counseling and Preventive Medication)

Promoting a Healthy Pregnancy: Clinical Preventive Services for Pregnant Women



1 National Heart, Lung, and Blood Institute, Department of Health and Human Services, National Institutes of Health. What are Congenital Heart Defects? Available at:
http://www.nhlbi.nih.gov/health/dci/Diseases/chd/chd_what.html

2 Jenkins KJA, Correa A, Feinstein JA, Botto L, Britt AE, Daniels SR, Elixson M, Warnes CA, Webb CL. Noninherited Risk Factors and Congenital Cardiovascular Defects: Current Knowledge. A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young. Endorsed by the American Academy of Pediatrics. Circulation. May 22, 2007: CIRCULATIONAHA.106.183216.

3 Centers for Disease Control and Prevention. Hospital Stays, Hospital Charges, and In-Hospital Deaths Among Infants with Selected Birth Defects— United States, 2003. MMWR 2007;56:27-29.

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