Maternal Periconceptional Alcohol Consumption and Congenital Limb Deficiencies
Maternal Periconceptional Alcohol Consumption and Congenital Limb Deficiencies
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DOI：
10.1002/bdra.23292
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发表时间：
2014-11-01
影响因子：
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通讯作者：
Richardson, Sandra D.
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文献类型：
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作者：
Conway, Kristin M. Caspers;Romitti, Paul A.;Richardson, Sandra D.
背景：育龄妇女报告高饮酒率，这可能导致怀孕早期的酒精暴露。关于先天性肢体缺陷(LDS)和孕周酒精暴露的流行病学研究尚无定论。方法：根据国家出生缺陷预防研究(NBDPS)的数据，在预计分娩日期为1997年10月至2007年12月的LD病例(n=906)和未受影响的对照组(n=8352)中，分析LDS与母亲孕周(怀孕前1个月至妊娠早期)饮酒方式的关系。所有LD组合、特定的LD亚型(轴前/终末横形)和LD解剖组(上肢/下肢)的调整优势比(AORS)和95%可信区间由非条件Logistic回归分析估计，并检验补充叶酸(FA)的交互作用。结果：与不饮酒者相比，所有LDS的合并、轴前和上位LDS与任何已报告的概念周围饮酒(AORS范围为0.56-0.83)、不酗酒(AORS：0.53-0.75)和酗酒(4杯/场合)(AORS：0.64-0.94)呈负相关；然而，狂欢饮酒的AORS均无统计学意义。按酒精类型分层显示，在不喝葡萄酒的所有合并LD、轴前、横向和上下LD之间(AORS：0.39-0.67)，在饮用不结合酒精的所有LD之间(AORS：0.63-0.87)。FA没有改变观察到的关联。结论：在NBDPS中，母亲孕周饮酒并不是特定LDS的致畸因素。未来的研究应该评估更高暴露人群中更多的稀有LDS。出生缺陷研究(A部分)100：863-876,2014。(C)2014年威利期刊公司。
Background: Women of childbearing age report high rates of alcohol consumption, which may result in alcohol exposure during early pregnancy. Epidemiological research on congenital limb deficiencies (LDs) and periconceptional exposure to alcohol is inconclusive. Methods: Data from the National Birth Defects Prevention Study (NBDPS) were examined for associations between LDs and patterns of maternal periconceptional (1 month before conception through the first trimester) alcohol consumption among LD case (n=906) and unaffected control (n=8352) pregnancies with expected delivery dates from 10/1997 through 12/2007. Adjusted odds ratios (aORs) and 95% confidence intervals were estimated from unconditional logistic regression analysis for all LDs combined, specific LD subtypes (preaxial/terminal transverse), and LD anatomic groups (upper/lower limbs); interactions with folic acid (FA) supplementation were tested. Results: When compared with nondrinkers, inverse associations were found between all LDs combined, preaxial, and upper LDs and any reported periconceptional alcohol consumption (aORs ranged from 0.56-0.83), drinking without binging (aORs: 0.53-0.75), and binge drinking (4 drinks/occasion) (aORs: 0.64-0.94); however, none of the binge drinking aORs were statistically significant. Stratification by alcohol type showed inverse associations between all LDs combined, preaxial, transverse, and upper and lower LDs for drinking without binging of wine only (aORs: 0.39-0.67) and between all LDs combined and upper LDs for drinking without binging of combinations of alcohol (aORs: 0.63-0.87). FA did not modify observed associations. Conclusion: Maternal periconceptional alcohol consumption did not emerge as a teratogen for selected LDs in the NBDPS. Future studies should evaluate additional rare LDs among more highly exposed populations. Birth Defects Research (Part A) 100:863-876, 2014. (c) 2014 Wiley Periodicals, Inc.