Panel from a prenatal health poster from the March of Dimes.

March in February: Congenital Heart Defects Awareness

By Ginny A. Roth ~

A nine-panel series of cartoons that outline steps for good prenatal health and nutrition. Images include a doctor listening to a woman's heart, a cow surrounded by calcium-rich foods, groups of grains, proteins, fruits and vegetables, a woman walking, possible sources of harm for the fetus, and a woman weighing herself.
March of Dimes poster drawn in cartoon-format to illustrate steps to proper prenatal care and nutrition, 1986
National Library of Medicine #101438082

Today is Valentines Day, a day associated with hearts. In fact, the entire month of February is American Heart Month. As part of this national health observation, February 7-14, 2019 is Congenital Heart Defect Awareness Week.

The poster featured above was published by March of Dimes in 1986. The poster is a nine-panel series of cartoons that outlines the steps for proper prenatal health. The images illustrate messages such as eat calcium-rich foods, get exercise, and avoid cigarettes and alcohol. The March of Dimes still encourages women to practice good prenatal health, you can see their current recommendations on their website, and find more resources like this on MedlinePlus.

March of Dimes, a non-profit health organization seeks, through education and advocacy, to improve the health of babies by preventing birth defects, infant mortality, and premature birth.  The organization was founded in 1938 by Franklin D. Roosevelt as The National Foundation for Infantile Paralysis as a response to United States’ epidemics of polio, a viral disease which can cause paralysis, and that Roosevelt himself was diagnosed with in 1921.

Following widespread use of the polio vaccine in the 1950s, the organization changed its focus in 1958 to birth defects prevention. Although now, over 60 years later, doctors still do not know the causes for all congenital heart defects, they do know that genetics and certain risk factors during pregnancy play a role, such as obesity, diabetes, taking certain medications, and smoking. In 1979 the organization officially changed its name to the March of Dimes Birth Defects Foundation

The name “March of Dimes” was actually coined over 4 decades prior to the organization’s name change by vaudeville star and comedian Eddie Cantor, who also helped promote humanitarian causes, including the campaign against polio. In 1937, at a meeting with several fundraising organizers, Cantor suggested that money raised during an annual radio broadcast could be directed to President Roosevelt. Cantor said, “We could call it the March of Dimes,” a pun based on the contemporary newsreel, The March of Time.  The first March of Dimes radio appeal, with Cantor expressing the nation’s solidarity with the President and his fight against polio, occurred in January 1938 during the week preceding FDR’s birthday.

A congenital heart defect (CHD) is present at birth and is a condition that can affect the structure of a baby’s heart and how blood flows through the heart to the rest of the body. Examples of CHDs are a hole in the heart or parts of the heart being malformed or missing completely. CHDs are the most common types of birth defects, with nearly 1 in 100 babies (about 1% or 40,000 babies) born with a heart defect in the United States each year.

An article in the American Heart Association journal, Circulation, states that advancements in care have led to a decline in mortality from CHDs over the past several decades. However, no current data documenting the number of people living with CHDs in the United States exists. The article estimates, based on data gathered from administrative healthcare databases in Québec, Canada, that nearly 1.4 million adults and 1 million children were living with CHDs in the United States in 2010.

According to the Centers for Disease Control and Prevention, although there are a number of state-based birth defects programs that track CHDs among newborns and young children, there are no population-based tracking systems that exist to look at the growing population of older children and adults with heart defects. The CDC began pilot projects in 2012 with health organizations and institutions in order to better understand the survival, healthcare use, and longer term outcomes of individuals born with CHDs across the lifespan. The CDC also started a partnership with March of Dimes to conduct a survey of adults with CHDs. The survey, CHSTRONG, Congenital Heart Survey To Recognize Outcomes, Needs, and Well-beinG, closed at the end of 2018.

Many organizations take part in CHD Awareness Week, such as Mended Hearts, a non-profit organization that offers peer-to-peer support for heart patients and their families. Mended Little Hearts is specifically for the support of children with CHDs.

The Pediatric Congenital Heart Association sponsors programs that serve to educate patients, parents, physicians, and lawmakers. For CHD Awareness Week their goal is to inform those who may not be familiar with pediatric CHDs and urge those supporting the cause to comment on social media using the hashtag #CHDAware with details about personal stories, experiences, and CHD issues that matter the most to those who post.

The CDC provides a page with numerous other resources on the topic of CHDs.

Care and treatment for individuals with CHDs varies and the American Heart Association provides a detailed list of various conditions and treatment options. The National Heart, Lung, and Blood Institute also has a list of CHD-related clinical trials that are currently recruiting patients.

During this important month that focuses on heart health, enjoy the celebration of Valentines Day, but also remember to be good to your heart, and to those who may need extra support with theirs.

See posters related to heart-health from the Prints & Photographs collection featured in NLM In Focus. 

Ginny A. Roth is the Curator of Prints & Photographs in the History of Medicine Division at the National Library of Medicine.

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