Abstract

Objective: Maternal nutrition is increasingly recognized as a modifiable determinant of fetal cardiovascular development. Experimental and epidemiological studies suggest that iron deficiency may contribute to congenital heart disease, but data focusing on ventricular septal defect (VSD) remain limited. This study aimed to evaluate the association between maternal iron status and isolated perimembranous VSD in offspring.

Materials and Methods: This single-center retrospective case–control study included mothers of 41 infants younger than one year with isolated perimembranous VSD and 38 control mothers whose infants had no structural heart disease after echocardiographic evaluation. Maternal laboratory parameters were retrieved from electronic medical records, and the earliest available results were used for analysis. Evaluated parameters included hemoglobin, ferritin, vitamin B12, folate, and 25-hydroxyvitamin D. Group comparisons were performed using the Mann–Whitney U test or chi-square test, as appropriate. Binary logistic regression was used to assess independent associations with VSD, and receiver operating characteristic analysis was performed for ferritin.

Results: Maternal ferritin levels were significantly lower in the VSD group than in controls (median 25.8 [IQR 15.5–52.0] vs 57.9 [IQR 21.3–79.3] ng/mL, p=0.012), whereas maternal hemoglobin, vitamin B12, folate, and vitamin D levels did not differ significantly. In multivariable logistic regression adjusted for maternal age, hemoglobin, vitamin B12, and folate, ferritin remained independently associated with VSD (OR 0.83 per 10-ng/mL increase, 95% CI 0.72–0.96, p=0.012). Ferritin showed moderate discriminative ability for VSD (AUC 0.665, 95% CI 0.537–0.781).

Conclusion: Lower maternal ferritin levels were associated with isolated perimembranous VSD in offspring, independent of hemoglobin levels. These findings suggest that reduced maternal iron stores may be relevant to fetal septal development and warrant confirmation in prospective studies with measurements obtained during early pregnancy.

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Copyright © 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Aydemir MM, Çeliktepe V, Demir E, Çağlar T, Tahiroğlu V. Maternal iron status in mothers of infants with ventricular septal defect: A retrospective case–control study. Turk J Pediatr Dis. 2026;Early View:1-6. https://doi.org/10.12956/TJPD.2026.1333