title: Maternal injuries during the periconceptional period and the risk of birth defects, National Birth Defects Prevention Study, 1997-2005.
abstract: Maternal injuries during pregnancy are common (∼7% prevalence). However, few studies have examined the association between maternal injuries and birth defects. The National Birth Defects Prevention Study is a population-based case-control study of birth defects in 10 U.S. states. Cases were ascertained through surveillance; controls were randomly selected from infants delivered without major birth defects in the study regions. Mothers completed a telephone interview on exposures before and during pregnancy, including injuries. We assessed associations between periconceptional (month before until the end of the third month of pregnancy) maternal injuries and birth defects. We used logistic regression to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CI). Periconceptional injuries were associated with interrupted aortic arch type B [AOR = 5.2, 95% CI 1.2, 23.2]; atrioventricular septal defect [AOR = 2.2, 95% CI 1.1, 4.4]; pulmonary atresia [AOR = 3.2, 95% CI 1.6, 6.4]; tricuspid atresia [AOR = 2.8, 95% CI 1.2, 6.7]; hypoplastic left heart syndrome [AOR = 2.0, 95% CI 1.1, 3.4]; anorectal atresia/stenosis [AOR = 1.7, 95% CI 1.0, 2.7]; longitudinal limb deficiency [AOR = 2.1, 95% CI 1.1, 3.9]; and gastroschisis [AOR = 1.8, 95% CI 1.2, 2.8]. Associations with longitudinal limb deficiency, gastroschisis and hypoplastic left heart syndrome were stronger for intentional injuries. Our results suggest maternal injury during the periconceptional period, particularly those inflicted intentionally, may be associated with select birth defects. This analysis was hypothesis-generating, with many associations tested. Further research is warranted.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Tinker
authors.forename: Jennita
authors.initials: J
authors.lastname: Reefhuis
authors.forename: Ann M
authors.initials: AM
authors.lastname: Dellinger
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D009035:Mothers; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012044:Regression Analysis; D012306:Risk; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult