title: Periconceptional maternal alcohol consumption and neural tube defects.
abstract: BACKGROUND
  Neural tube defects (NTD)s, which occur when the neural tube fails to close during early gestation, are some of the most common birth defects worldwide. Alcohol is a known teratogen and has been shown to induce NTDs in animal studies, although most human studies have failed to corroborate these results. Using data from the National Birth Defects Prevention Study, associations between maternal reports of periconceptional (1 month prior through 2 months postconception) alcohol consumption and NTDs were examined.
  
  
  METHODS
  NTD cases and unaffected live born control infants, delivered from 1997 through 2005, were included. Interview reports of alcohol consumption (quantity, frequency, variability, and type) were obtained from 1223 case mothers and 6807 control mothers. Adjusted odds ratios (aOR)s and 95% confidence intervals were estimated using multivariable logistic regression analysis.
  
  
  RESULTS
  For all NTDs combined, most aORs for any alcohol consumption, one or more binge episodes, and different type(s) of alcohol consumed were near unity or modestly reduced (≥ 0.7 < aOR ≤ 1.1) and were not statistically significant. Findings were similar for individual NTD subtypes.
  
  
  CONCLUSIONS
  These findings suggest no elevated association between maternal periconceptional alcohol consumption and NTDs. Underreporting of alcohol consumption, due to negative social stigma associated with alcohol consumption during pregnancy, and limited reports for mothers with early pregnancy loss of a fetus with an NTD may have affected the estimated odds ratios. Future studies should aim to increase sample sizes for less prevalent subtypes, reduce exposure misclassification, and improve ascertainment of fetal deaths and elective terminations.
authors: Department of Epidemiology, The University of Iowa, Iowa City, Iowa 52242, USA.
authors: Jennifer A
authors: JA
authors: Makelarski
authors: Paul A
authors: PA
authors: Romitti
authors: Lixian
authors: L
authors: Sun
authors: Trudy L
authors: TL
authors: Burns
authors: Charlotte M
authors: CM
authors: Druschel
authors: Lucina
authors: L
authors: Suarez
authors: Andrew F
authors: AF
authors: Olshan
authors: Anna Maria
authors: AM
authors: Siega-Riz
authors: Richard S
authors: RS
authors: Olney
mesh_terms: D000022:Abortion, Spontaneous; D000428:Alcohol Drinking / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008425:Maternal Behavior; D018811:Maternal Exposure; D009035:Mothers; D009436:Neural Tube Defects / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011795:Surveys and Questionnaires