Maternal periconceptional smoking and alcohol consumption and risk for select congenital anomalies.
BACKGROUND
This study examined the association between maternal smoking and alcohol use (including binge drinking) during the periconceptional period (i.e., 2 months before through 2 months after conception) and the risk of orofacial clefts, NTDs, and conotruncal heart defects in offspring.


METHODS
Data were drawn from a population-based case-control study of fetuses and live-born infants among a cohort of California births between July 1999 and June 2003. The 1,355 cases comprised of 701 orofacial clefts, 337 NTDs, and 323 conotruncal heart defects. Information on smoking and alcohol consumption was obtained via telephone interviews with mothers of 1,355 (80% of eligibles) cases and 700 (77% of eligibles) nonmalformed, live-born controls.


RESULTS
Maternal smoking of five cigarettes or less per day was associated with reduced risks of NTDs (OR 0.7; 95% CI: 0.3, 1.4), whereas the risk associated with higher cigarette consumption was lower for conotruncal heart defects (OR 0.5; 95% CI: 0.2, 1.2). Maternal intake of alcohol less than 1 day per week was associated with a 1.6- to 2.1-fold higher risk of NTDs (95% CI: 0.9, 2.6), d-transposition of the great arteries (95% CI: 1.1, 3.2), and multiple cleft lip with or without cleft palate (CLP) (95% CI: 0.8, 4.5). Risks associated with more frequent alcohol intake were 2.1 for NTDs (95% CI: 1.1, 4.0) and 2.6 for multiple CLP (95% CI: 1.1, 6.1).


CONCLUSIONS
This study observed that maternal alcohol intake increased the risk for d-transposition of the great arteries, NTDs, and multiple CLP in infants. By contrast, smoking was associated with a lower risk of NTDs and conotruncal heart defects.
Grewal
Jagteshwar
J
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
Carmichael
Suzan L
SL
Ma
Chen
C
Lammer
Edward J
EJ
Shaw
Gary M
GM
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D002971:Cleft Lip / Q000453:epidemiology / Q000209:etiology; D002972:Cleft Palate / Q000453:epidemiology / Q000209:etiology; D000431:Ethanol / Q000506:poisoning; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D009056:Mouth Abnormalities / Q000453:epidemiology* / Q000209:etiology; D009436:Neural Tube Defects / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013689:Telephone
D000431:Ethanol