Parental cigarette smoking and risk for congenital anomalies of the heart, neural tube, or limb
✍ Scribed by Wasserman, Cathy R.; Shaw, Gary M.; O'Malley, Cynthia D.; Tolarova, Marie M.; Lammer, Edward J.
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 706 KB
- Volume
- 53
- Category
- Article
- ISSN
- 0040-3709
No coin nor oath required. For personal study only.
✦ Synopsis
Risks for selected congenital anomalies from parental smoking were investigated in a case-control study in California. Mothers of 207 infants with conotruncal heart defects, 264 infants with neural tube defects, 178 infants with limb deficiencies, and 481 live born control infants delivered in 1987-1 988 were interviewed by telephone. Modestly elevated risks were observed for conotruncal heart defects and limb deficiencies, associated primarily with both parents smoking. An odds ratio of 1.9 (95 percent confidence interval 1.2-3.1) was observed for conotruncal heart defects and an odds ratio of 1.7 (95% confidence interval 0.96-2.9) for limb deficiencies when both parents smoked compared to neither parent smoking. We did not observe increased risks associated with maternal smoking in the absence of paternal smoking, although an increased risk associated with paternal smoking in the absence of maternal smoking was observed for limb deficiencies in offspring. For conotruncal defects, the risks associated with parental smoking differed among race/ ethnic groups. Parental smoking was not associated with increased risks for neural tube defects.
Observed risks did not change substantially when adjusted for maternal vitamin use, alcohol use, and gravidity. Some heterogeneity in risk was observed for phenotypic case subgroups, but data were too sparse to draw firm inferences. 0 1996 Wiley-Liss, Inc. '91).
Diagnostic information was reviewed by medical geneticists (E.J.L., M.M.T.) to determine eligibility. Eligible as conotruncal heart defect cases were all infants with malformations affecting aorticopulmonary septation, including: tetralogy of Fallot, d-transposition of the great arteries, truncus arteriosus communis, double outlet right ventricle, pulmonary valve atresia with ventricular septa1 defect (VSD), subaortic VSD type I, and aortico-pulmonary window. Cardiac malformations were confirmed by echocardiography, cardiac catheterization, surgery, or autopsy. When multiple cardiac diagnoses were present, the primary diagnosis was determined according to a hierarchical pathogenetic classification scheme (Clark, '90). All infants and fetuses (including elective terminations and spontaneous abortions) with diagnoses of anencephaly, spina bifida cystica, craniorhachischisis, and iniencephaly that were confirmed by autopsy, surgery report, or X