Attention turned much in recent years to the relation of these malformations to deficiency of a particular dietary ingredient, folic acid, a subject this book analyzes in depth. The greatest conundrum of all, which this latest matter like so much else hinges on, is the amazing fact of the tremendous, almost universal decrease in the frequency of these anomalies since early in the 20th century. The puzzle is 'What can this downward trend possibly mean?' and at bottom 'Whether it is part of a long-term cyclical pattern'. This fascinating biological phenomenon is explored in the book together with various other topics.
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"This is an epidemiologist's approach to congenital malformations of the heart which relates those malformations to infant and perinatal mortality. ... It is written for anyone who cares for patients with congenital heart disease: pediatric cardiologists, adult congenital heart disease practitioners, nurses, surgeons, and anesthesiologists. It is really written for everyone in the entire field of congenital heart disease." (Douglas Moodie, Doody's Book Review, October, 2007)