Exploring the potential to use data linkage for investigating the relationship between birth defects and prenatal alcohol exposure
Article first published online: 3 JUL 2013
Copyright © 2013 Wiley Periodicals, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 97, Issue 7, pages 497–504, July 2013
How to Cite
O'Leary, C. M., Elliott, E. J., Nassar, N. and Bower, C. (2013), Exploring the potential to use data linkage for investigating the relationship between birth defects and prenatal alcohol exposure. Birth Defects Research Part A: Clinical and Molecular Teratology, 97: 497–504. doi: 10.1002/bdra.23142
- Issue published online: 19 JUL 2013
- Article first published online: 3 JUL 2013
- Manuscript Accepted: 30 MAR 2013
- Manuscript Revised: 27 MAR 2013
- Manuscript Received: 11 FEB 2013
- Australian National Health and Medical Research Council (NHMRC) Public Health (Australia) Fellowship. Grant Number: 594451
- NHMRC program grant. Grant Number: 572742
- NHMRC Career Development Fellowship. Grant Number: 632655
- NHMRC Research Fellowship. Grant Number: 634341
- NHMRC Practitioner Fellowship. Grant Number: 457084
- infrastructure grants from Curtin University and the Western Australian Drug and Alcohol Office
- alcohol abuse;
- alcohol and pregnancy;
- birth defects;
- congenital anomalies;
- data linkage
This study explores the potential of data linkage to investigate the proportion of birth defects classified as alcohol-related (ARBD) by the Institutes of Medicine (IOM) that are attributable to maternal alcohol-use disorder.
Maternal alcohol-use disorder was identified using International Classification of Diseases (9th and 10th revision) codes for alcohol-related diagnoses recorded on record-linked Western Australian health, mental health, and/or drug and alcohol datasets 1983 to 2007. Children of these mothers (n = 23,859) were compared with a randomly selected cohort of children born to mothers without an alcohol diagnosis, frequency-matched by maternal age, Aboriginal status, and child's birth year (n = 61,370). Birth defects were identified through linkage with the Western Australian Register of Developmental Anomalies and defects with chromosomal causes were excluded. Associations between overall and individual IOM-designated ARBD and a maternal alcohol-related diagnosis recorded “during pregnancy” or “any” diagnosis (before/during/after pregnancy) was assessed using multivariate logistic regression to generate odds ratios and 95% confidence intervals. Population-attributable fractions were calculated for significant results using total population numbers.
There was a significant association between maternal alcohol-related diagnoses recorded during pregnancy and ARBD (adjusted odds ratio, 3.14; 95% confidence interval, 2.49–3.96), with an attributable fraction of 0.57%. “Any” maternal alcohol diagnosis demonstrated a higher attributable fraction for ARBD (1.53%), with the highest attributable fractions for microcephaly (7.31%), ptosis (3.75%), atrial septal defect (2.86%), and conotruncal heart defects (2.01%).
Research using linked, population-based administrative health data has the potential to advance knowledge of ARBD. Routine collection and recording of alcohol use during pregnancy for all pregnant women is required and would enhance this methodology. Birth Defects Research (Part A) 97:497–504, 2013. © 2013 Wiley Periodicals, Inc.