Effect of maternal smoking and coffee consumption on the risk of having a recognized Down syndrome pregnancy.
To evaluate the possible effects of maternal smoking and caffeine or coffee consumption on the occurrence of a recognized pregnancy with Down syndrome, the authors analyzed data from a case-control study of 997 liveborn infants or fetuses with Down syndrome ascertained in California from 1991 to 1993 and 1,007 liveborn controls without a birth defect. Interviews with mothers covered demographic information, pregnancy, and medical history, with detailed questions on the use of tobacco, alcohol, and caffeinated beverages. All analyses were age-adjusted. High alcohol consumption (> or =4 drinks/week) in the first month of pregnancy was associated with reduced risk for a recognized Down syndrome conceptus (odds ratio (OR) = 0.54; 95% confidence interval (CI): 0.34, 0.85). Maternal smoking during the periconceptional period was not associated with risk of recognized Down syndrome (OR = 1.04; 95% CI: 0.79, 1.37), but maternal consumption of four or more cups of coffee per day was inversely associated (OR = 0.63; 95% CI: 0.41, 0.96). In multivariate analysis, a significant interaction between coffee drinking and smoking was observed. The inverse association remained only for nonsmoking mothers who drank four or more cups of coffee per day (OR = 0.48; 95% CI: 0.28, 0.82). These results suggest that among nonsmoking mothers, high coffee consumption is more likely to reduce the viability of a Down syndrome conceptus than that of a normal conceptus.
Torfs
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CP
California Birth Defects Monitoring Program, Oakland 94606-5226, USA. cptorfs@cbdmp.org
Christianson
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D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D003069:Coffee / Q000009:adverse effects; D015897:Comorbidity; D016001:Confidence Intervals; D004314:Down Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005313:Fetal Death; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011297:Prenatal Exposure Delayed Effects; D011336:Probability; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*
D003069:Coffee