Interaction between maternal smoking and malnutrition in infant risk of gastroschisis
Interaction between maternal smoking and malnutrition in infant risk of gastroschisis
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DOI：
10.1002/bdra.20238
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发表时间：
2006-03-01
影响因子：
--
通讯作者：
Torfs, CP
中科院分区：
文献类型：
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作者：
Lam, PK;Torfs, CP
背景：腹裂是一种严重的出生缺陷，其特征是婴儿腹壁撕裂。年轻母亲生下患有腹裂的婴儿的风险最高。在一个动物模型中，这种缺陷是由于怀孕的小鼠暴露在一氧化碳(CO)和低蛋白质、低锌饮食的组合下造成的。方法：我们对55名腹裂婴儿和94名年龄匹配的对照组进行了研究，其中包括对母亲的访谈和食物频率问卷。怀孕前3个月吸食香烟(一包/天)或吸食大麻(一次以上)表明有一氧化碳暴露。蛋白质或锌摄入量低以及体重指数(BMI)低表明母亲营养不良。结果：单独评估时，高CO、低蛋白质、低锌和低BMI均显著增加腹裂的风险。虽然在调整收入后，我们观察到显著的CO-BMI和CO-锌交互作用，但只有高CO暴露和低BMI的组合才会产生协同的不良影响。与体重指数不低且不吸烟的母亲相比，体重指数不低但吸烟的母亲生下婴儿腹裂的风险高16.3倍(95%CI，2.49-113.4)，不吸烟但体重指数低的母亲生婴儿腹裂的风险高19.7倍(95%CI，4.33-89.6)。然而，低BMI和吸烟的母亲的风险高出26.5倍(95%CI，7.85-89.4)。结论：我们的结果表明，如果年轻母亲吸烟并且营养不良，那么她们生下的婴儿腹裂的风险就会增加。出生缺陷研究(A部分)76：182-186,2006。(C)2006年Wiley-Liss，Inc.
BACKGROUND: Gastroschisis is a severe birth defect characterized by a tear in the infant's abdominal wall. Young mothers have the highest risk of having an infant with gastroschisis. In an animal model, the defect resulted from exposure of pregnant mice to carbon monoxide (CO) in combination with a low protein and low zinc diet. METHODS: We evaluated this model in a study of 55 infants with gastroschisis and 94 age-matched controls that included maternal interview with a food frequency questionnaire. Smoking cigarettes (>= 1 pack/day) or marijuana (more than once) 3 months prior to pregnancy indicated CO exposure. Low protein or zinc intake and a low body mass index (BMI) indicated maternal malnutrition. RESULTS: When assessed separately, high CO, low protein, low zinc, and low BMI were each significantly associated with an increased risk of gastroschisis. Although we observed significant CO-BMI and CO-zinc interactions after adjusting for income, only a combination of high CO exposure and low BMI yielded a synergistic adverse effect. Compared to the low risk of having an infant with gastroschisis for mothers who did not have low BMI and did not smoke, the risk of having an infant with gastroschisis was 16.3 times (95% CI, 2.49-113.4) higher for mothers who did not have low BMI but smoked, and 19.7 times (95% Cl, 4.33-89.6) higher for mothers who did not smoke but had low BMI. However, the risk was 26.5 times (95% Cl, 7.85-89.4) higher for mothers who had low BMI and smoked. CONCLUSIONS: Our results suggest that young mothers are at increased risk of having an infant with gastroschisis if they smoke and are also malnourished. Birth Defects Research (Part A) 76:182-186, 2006. (c) 2006 Wiley-Liss, Inc.