{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T22:12:31Z","timestamp":1772316751638,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5T32HL094274"],"award-info":[{"award-number":["5T32HL094274"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital heart disease (CHD) is the most common birth defect group and a significant contributor to neonatal and infant death. CHD with single ventricle anatomy, including hypoplastic left heart syndrome (HLHS), tricuspid atresia (TA), and various double\u2010inlet ventricle (DIV) malformations, is the most complex with the highest mortality. Prenatal risk factors associated with HLHS have been studied, but such data for DIV are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed DIV cases and nonmalformed controls in the National Birth Defects Prevention Study, a case\u2010control, multicenter population\u2010based study of birth defects. Random forest analysis identified potential predictor variables for DIV, which were included in multivariable models to estimate effect magnitude and directionality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Random forest analysis identified pre\u2010pregnancy diabetes, history of maternal insulin use, maternal total lipid intake, paternal race, and intake of several foods and nutrients as potential predictors of DIV. Logistic regression confirmed pre\u2010pregnancy diabetes, maternal insulin use, and paternal race as risk factors for having a child with DIV. Additionally, higher maternal total fat intake was associated with a reduced risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal pre\u2010pregnancy diabetes and history of insulin use were associated with an increased risk of having an infant with DIV, while maternal lipid intake had an inverse association. These novel data provide multiple metabolic pathways for investigation to identify better the developmental etiologies of DIV and suggest that public health interventions targeting diabetes prevention and management in women of childbearing age could reduce CHD risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1501","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T09:25:03Z","timestamp":1553765103000},"page":"640-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Risk factors associated with the development of double\u2010inlet ventricle congenital heart disease"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6720-5957","authenticated-orcid":false,"given":"Sharon L.","family":"Paige","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Stanford University School of Medicine  Palo Alto California"},{"name":"Stanford Cardiovascular Institute Stanford University School of Medicine  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Neonatal and Developmental Medicine, Department of Pediatrics Stanford University School of Medicine  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Priest","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Stanford University School of Medicine  Palo Alto California"},{"name":"Stanford Cardiovascular Institute Stanford University School of Medicine  Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo D.","family":"Botto","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics University of Utah  Salt Lake City 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