title: Maternal periconceptional alcohol consumption and congenital heart defects.
abstract: BACKGROUND
  Congenital heart defects (CHDs) are the leading cause of infant death from birth defects. Animal studies suggest in utero alcohol exposure is a teratogen for cardiogenesis; however, results from epidemiologic studies are mixed.
  
  
  METHODS
  Data from the National Birth Defects Prevention Study were used to estimate associations between CHDs and case (n = 7076) and control (n = 7972) mother reports of periconceptional (1 month before pregnancy through the first trimester) alcohol consumption with expected delivery dates during 1997 to 2007. CHDs were examined by category (conotruncal, septal, left ventricular outflow tract obstruction, and right ventricular outflow tract obstruction, heterotaxy with CHD) and subtype (e.g., tetralogy of Fallot [TOF]). Alcohol measures examined were any consumption, maximum average drinks per month, binge drinking, and alcohol type. Adjusted odds ratios and 95% confidence intervals were estimated using unconditional logistic regression analysis.
  
  
  RESULTS
  Increased risks, albeit marginally statistically significant, were observed for TOF and each maternal alcohol measure examined and for right ventricular outflow tract obstruction and heterotaxy with CHD and consumption of distilled spirits. Significantly reduced risks were observed for several CHD categories (septal defects, left ventricular outflow tract obstruction, and right ventricular outflow tract obstruction) and some corresponding subtypes with different alcohol measures. Significant risks were not observed for the other CHDs examined.
  
  
  CONCLUSIONS
  Analysis of this large, well-defined study sample did not show statistically significant increased risks between measures of maternal alcohol consumption and most CHDs examined. These findings may reflect, in part, limitations with retrospective exposure assessment or unmeasured confounders. Additional studies with continued improvement in measurement of alcohol consumption are recommended.
authors.affiliation: Department of Epidemiology, The University of Iowa, Iowa City, Iowa.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Epidemiology, The University of Iowa, Iowa City, Iowa.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Romitti
authors.affiliation: Department of Epidemiology, The University of Iowa, Iowa City, Iowa.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Caspers Conway
authors.affiliation: Department of Epidemiology, The University of Iowa, Iowa City, Iowa.
authors.forename: Dereck H
authors.initials: DH
authors.lastname: Shen
authors.affiliation: Department of Epidemiology, The University of Iowa, Iowa City, Iowa.
authors.forename: Lixian
authors.initials: L
authors.lastname: Sun
authors.affiliation: New York State Department of Health, Albany, New York.|School of Public Health, University at Albany, Rensselaer, New York.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Browne
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City, Utah.
authors.forename: Lorenzo D
authors.initials: LD
authors.lastname: Botto
authors.affiliation: Genetics Unit, MassGeneral Hospital for Children, Boston, Massachusetts.
authors.forename: Angela E
authors.initials: AE
authors.lastname: Lin
authors.affiliation: New York State Department of Health, Albany, New York.|School of Public Health, University at Albany, Rensselaer, New York.
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Druschel
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D016022:Case-Control Studies; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D008297:Male; D018811:Maternal Exposure; D008875:Middle Aged; D012307:Risk Factors; D014481:United States; D055815:Young Adult
keywords: alcohol; birth defects; congenital heart defects; epidemiology; pregnancy