In which situation is there the greatest risk that a newborn infant will have a congenital heart defect (CHD)?
a. Trisomy 21 detected on amniocentesis
b. Family history of myocardial infarction
c. Father has type 1 diabetes mellitus
d. Older sibling born with Turner's syndrome
ANS: A
The incidence of congenital heart disease is approximately 50% in children with trisomy 21 (Down syndrome). A family history of congenital heart disease, not acquired heart disease, increases the risk of giving birth to a child with CHD. Infants born to mothers who are insulin dependent have an increased risk of CHD. Infants identified as having certain genetic defects, such as Turner's syndrome, have a higher incidence of CHD.
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