Association Between a Mother's Exposure to "Strep Throat" and Her Baby's Developing Heart Disease

The primary objective of this study is to:

• measure maternal ß-hemolytic streptococcal carriage as defined by positive throat cultures in the absence of symptoms among Hypoplastic Left Heart Syndrome (HLHS) mothers.
• define the incidence of positive strep throat cultures among asymptomatic pregnant women, identified at <18 weeks gestation and followed to term.
• Measure antibodies that may cross react to select valvular/myocardial antigens in HLHS/Congenital Heart Defect(CHD)-other neonates born to mothers in the study
• determine serum and/or tissue reactivity against antibodies in matched maternal serum.

The secondary objectives of this study is to:

• measure maternal ß-hemolytic streptococcal serology using standard serology testing among HLHS mothers.
• determine the history of maternal ß-hemolytic streptococcal exposure using a study questionnaire among HLHS mothers.
• Determine "baseline" strep serologies and history of strep exposure among a cohort of asymptomatic pregnant women, identified at <18 weeks gestation and followed to term.

The overall purpose of this study is to evaluate the history of β-hemolytic streptococcal pharyngeal exposure, groups A, G and C ("strep throat") in pregnant women whose pregnancies have been complicated by the diagnosis of congenital heart disease. Our short-term goal is to identify a potential association of an antecedent maternal strep throat exposure in pregnancy to identify a subset of heart defects

• To determine if co-infections play a role in congenital heart defects

Inclusion criteria

• For Fetal pts:
• HLHS or variant diagnosis
• Other Congenital Heart Disease
• Greater than or = 20wks gestation
• For Healthy moms:
• No diagnosis of Congenital Heart Disease
• Greater than or = 20wks gestation

Exclusion criteria

• For fetal pts & healthy controls:
• Mom less than 18 years old
• Twins or multiple gestations
• Pregnancy affected by 2 or more congenital anomalies( in addition to heart defects)
• Pregnancy affected by OB complications like pre-eclampsia
• Known history of chromosomal anomaly or carrier status
• Pregnancy result of fertility treatment including in vitro fertilization
• Emotionally distress
• Mom received blood transfusion or immunoglobin infusion within 6 months of the pregnancy.