Maternal periconceptional alcohol consumption and congenital limb deficiencies

Authors

  • Kristin M. Caspers Conway,

    1. Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa
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  • Paul A. Romitti,

    Corresponding author
    1. Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa
    • Correspondence to: Paul A. Romitti, Department of Epidemiology, College of Public Health, The University of Iowa, S416 CPHB, 145 N Riverside Drive, Iowa City, IA 52242. E-mail: paul-romitti@uiowa.edu

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  • Lewis Holmes,

    1. Genetics and Teratology Unit, Massachusetts General Hospital, Boston, Massachusetts
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  • Richard S. Olney,

    1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Sandra D. Richardson,

    1. Congenital Malformations Registry, Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, New York
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  • the National Birth Defects Prevention Study


  • This work was supported by cooperative agreements from the Centers for Disease Control and Prevention to the Iowa Center for Birth Defects Research and Prevention participating in the National Birth Defects Prevention Study (U01/DD000492) and the Birth Defects Study To Evaluate Pregnancy exposureS (U01/DD001035).

Abstract

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. © 2014 Wiley Periodicals, Inc.

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