title: Maternal reproductive history and the risk of isolated congenital malformations.
abstract: We examined the relationship between maternal reproductive history and the newborn's risk of isolated congenital malformations in a large case-control cohort from the Polish Registry of Congenital Malformations. Congenital malformations were classified into four categories: isolated congenital heart defects (n=1673), isolated cleft palate (n=255), cleft lip with or without cleft palate (n=448) and renal agenesis (n=103). The case groups were compared with a shared group of 2068 controls recruited in the same time period and geographic area. Multivariable logistic regression was used to assess the risk associated with maternal gravidity and of previous miscarriages after accounting for maternal age and other potential risk factors. In unadjusted analyses, maternal gravidity was significantly associated with increased risk of all four classes of congenital malformations. After adjustment, a significant association persisted for congenital heart defects [odds ratio (OR)=1.22, [95% confidence interval (CI) 1.09, 1.36], P=0.0007] and cleft lip with or without cleft palate (OR=1.21, [95% CI 1.09, 1.36], P=0.0005). A similar trend existed for isolated cleft palate (OR=1.18, [95% CI 1.02, 1.37], P=0.03). There was no appreciable increase in the risk of congenital malformations associated with a maternal history of miscarriages, but a trend for a protective effect on the occurrence of cleft lip with or without cleft palate was observed (OR=0.72, [95% CI 0.52, 0.99], P=0.045). Based on our data, maternal gravidity represents a significant risk factor for congenital heart defects and cleft lip with or without cleft palate in the newborn infant. Our data do not support an increase in risk because of past history of miscarriages.
authors.affiliation: Department of Medical Genetics, Poznań University of Medical Sciences, Poznań, Poland. akiryluk@ump.edu.pl
authors.forename: A
authors.initials: A
authors.lastname: Materna-Kiryluk
authors.forename: B
authors.initials: B
authors.lastname: Więckowska
authors.forename: K
authors.initials: K
authors.lastname: Wiśniewska
authors.forename: M K
authors.initials: MK
authors.lastname: Borszewska-Kornacka
authors.forename: U
authors.initials: U
authors.lastname: Godula-Stuglik
authors.forename: J
authors.initials: J
authors.lastname: Limon
authors.forename: J
authors.initials: J
authors.lastname: Rusin
authors.forename: H
authors.initials: H
authors.lastname: Sawulicka-Oleszczuk
authors.forename: E
authors.initials: E
authors.lastname: Szwałkiewicz-Warowicka
authors.forename: M
authors.initials: M
authors.lastname: Walczak
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002971:Cleft Lip / Q000453:epidemiology / Q000209:etiology*; D002972:Cleft Palate / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D020073:Gravidity; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities; D007674:Kidney Diseases / Q000151:congenital; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D016017:Odds Ratio; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D017584:Reproductive History; D012307:Risk Factors; D055815:Young Adult