title: Maternal Alcohol Consumption before and during Pregnancy and the Risks of Congenital Heart Defects in Offspring: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  Epidemiologic studies have reported conflicting results regarding maternal alcohol consumption before and during pregnancy, and the risk of congenital heart defects (CHDs). However, a systematic review and meta-analysis of the association between maternal alcohol consumption and CHDs in offspring has not been conducted.
  
  
  METHODS
  We searched MEDLINE and EMBASE for articles catalogued between their inception and February 16, 2015; we identified relevant published studies that assessed the association between maternal alcohol consumption and CHD risk. Two authors independently assessed the eligibility of the retrieved articles and extracted data from them. Study-specific relative risk estimates were pooled by random-effects or fixed-effects models.
  
  
  RESULTS
  From the 1527 references, a total of 19 case-control studies and four cohort studies were enrolled in this meta-analysis. The summary of 23 studies related to CHDs indicated an overall pooled relative risk of 1.13 (95% confidence interval: 0.96, 1.29) among mothers drinking before or during pregnancy. Statistically significant heterogeneity was detected (Q = 196.61, P < .001, I(2) = 88.8%) with no publication bias (Egger's test: P = .157). We conducted stratified and meta-regression analyses to identify the origin of the heterogeneity among studies.
  
  
  CONCLUSIONS
  In summary, this meta-analysis provided no positive association between maternal alcohol consumption and risk of CHDs.
authors.affiliation: School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.|Department of Anesthesiology, Huai'an Maternal and Child Health Hospital, Huai'an, Jiangsu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Nephrology, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Chen
authors.affiliation: School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Huajun
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
authors.forename: Zhengliang
authors.initials: Z
authors.lastname: Ma
authors.affiliation: School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis / Q000209:etiology*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D018570:Risk Assessment; D012307:Risk Factors
keywords: Alcohol; Congenital Heart Defects; Meta-analysis; Pregnancy