generalpopulation:changingprevalenceandage
distribution.Circulation.2007;115:163–172.
46.GatzoulisMA,HechterS,SiuSC,WebbGD.
Outpatientclinicsforadultswithcongenital
heartdisease:increasingworkloadandevolving
patternsofreferral.Heart.1999;81:57–61.
47.MarelliAJ,MackieAS,Ionescu-IttuR,Rahme
E,PiloteL.Congenitalheartdiseaseinthe
generalpopulation:changingprevalenceandage
distribution.Circulation.2007;115:163–172.
48.EngelfrietP,BoersmaE,OechslinE,etal.The
spectrumofadultcongenitalheartdiseasein
Europe:morbidityandmortalityina5year
follow-upperiod.TheEuroHeartSurveyon
adultcongenitalheartdisease.EurHeartJ.
2005;26:2325–2333[SRC-GoogleScholar].
49.GilboaSM,DevineOJ,KucikJE,etal.
CongenitalheartdefectsintheUnitedStates:
estimatingthemagnitudeoftheaffected
populationin2010.Circulation.2016;134:101–
109.
50.MackieAS,PiloteL,Ionescu-IttuR,RahmeE,
MarelliAJ.Healthcareresourceutilizationin
adultswithcongenitalheartdisease.AmJ
Cardiol.2007;99:839–843[SRCGoogleScholar].
51.MoonsP,SiebensK,DeGeestS,etal.Apilot
studyofexpenditureson,andutilizationof
resourcesin,healthcareinadultswith
congenitalheartdisease.CardiolYoung.
2001;11:301–313.
52.LenkeRR,LevyHL.Maternalphenylketonuria
andhyperphenylalaninemia.Aninternational
surveyoftheoutcomeofuntreatedandtreated
pregnancies.NEnglJMed.1980;303:1202–
1208.
53.LevyHL,GuldbergP,GuttlerF,etal.Congenital
heartdiseaseinmaternalphenylketonuria:report
fromtheMaternalPKUCollaborativeStudy.
PediatrRes.2001;49:636–642.
54.MatalonKM,AcostaPB,AzenC.Roleof
nutritioninpregnancywithphenylketonuriaand
birthdefects.Pediatrics.2003;112:1534–1536.
55.RouseB,AzenC.Effectofhighmaternalblood
phenylalanineonoffspringcongenitalanomalies
anddevelopmentaloutcomeatages4and6
years:theimportanceofstrictdietarycontrol
preconceptionandthroughoutpregnancy.J
Pediatr.2004;144:235–239.
56.FerenczC,LoffredoCA,Correa-VillasenorA,
WilsonPD.GeneticandEnvironmentalRisk
FactorsofMajorCardiovascular
Malformations:TheBaltimore-Washington
InfantStudy.FuturaPublishingCompanyInc:
Armonk,NY;1997:1981–1989.
57.Ramos-ArroyoMA,Rodriguez-PinillaE,
CorderoJF.Maternaldiabetes:theriskfor
specificbirthdefects.EurJEpidemiol.
1992;8:503–508.
58.BecerraJE,KhouryMJ,CorderoJF,EricksonJD.
Diabetesmellitusduringpregnancyandtherisks
forspecificbirthdefects:apopulation-based
case-controlstudy.Pediatrics.1990;85:1–9.
59.BowerC,StanleyF,ConnellAF,GentCR,
MasseyMS.Birthdefectsintheinfantsof
aboriginalandnon-aboriginalmotherswith
diabetesinWesternAustralia.MedJAust.
1992;156:520–524.
60.BottoLD,EricksonJD,MulinareJ,LynbergMC,
LiuY.Maternalfever,multivitaminuse,and
selectedbirthdefects:evidenceofinteraction?
Epidemiology.2002;13:485–488.
61.TikkanenJ,HeinonenOP.Maternalhyperthermia
duringpregnancyandcardiovascular
malformationsintheoffspring.EurJEpidemiol.
1991;7:628–635.
62.ZhangJ,CaiWW.Associationofthecommon
coldinthefirsttrimesterofpregnancywithbirth
defects.Pediatrics.1993;92:559–563.
63.ScanlonKS,FerenczC,LoffredoCA,etal.
Preconceptionalfolateintakeandmalformations