Maternal and paternal risk factors for anorectal malformations: A Dutch case-control study

✍ Scribed by Iris A. L. M. van Rooij; Charlotte H. W. Wijers; Paul N. M. A. Rieu; Hester S. Hendriks; Marijn M. Brouwers; Nine V. Knoers; Ivo de Blaauw; Nel Roeleveld

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 96 KB
• Volume: 88
• Category: Article
• ISSN: 1542-0752
• DOI: 10.1002/bdra.20649

✦ Synopsis

Abstract

BACKGROUND

Anorectal malformations (ARM) are major congenital malformations that usually require a multitude of surgical procedures at a very early age and have a large impact on the lives of patients and their parents. The causes of ARM are still largely unknown, but they are assumed to have a multifactorial etiology. A few studies focused on environmental risk factors, but evidence is still scarce.

METHODS

In this Dutch case‐control study (1996–2008), we investigated the role of maternal and paternal risk factors in the etiology of ARM. Parents of 85 ARM cases and 650 controls filled in a questionnaire. Controls were children treated with ear ventilation tubes.

RESULTS

A higher occurrence of fever during the first trimester of pregnancy was found for case mothers compared to control mothers (odds ratio [OR], 5.1; 95% Confidence Interval [CI], 0.9, 28.1). Maternal occupational exposure to industrial cleaning agents and solvents increased the risk of ARM three times (OR, 2.9; 95% CI, 0.9, 9.3). Overweight (Body Mass Index [BMI] ≥ 25 kg/m^2^) before pregnancy also seemed to be associated with ARM (OR, 1.8; 95% CI, 1.1, 2.8), as well as maternal multivitamin use during pregnancy (OR, 1.6; 95% CI, 1.0, 2.7), paternal smoking (OR, 1.8; 95% CI, 1.1, 2.9), and paternal occupational exposure to exhaust fumes (OR, 1.9; 95% CI, 1.0, 3.6). Reported ARM in at least one first‐ or second‐degree family member greatly increased the risk of having a child with an ARM (OR, 40.3; 95% CI, 4.8, 342.8).

CONCLUSIONS

This study revealed potential risk factors for ARM, including fever during pregnancy, maternal overweight, use of multivitamins, paternal smoking, and occupational exposures, but a familial component seems important as well. Birth Defects Research (Part A), 2010. © 2010 Wiley‐Liss, Inc.