Maternal periconceptional exposure to cigarette smoking and congenital limb deficiencies

Kristin M Caspers; Paul A Romitti; Shao Lin; Richard S Olney; Lewis B Holmes; Martha M Werler; National Birth Defects Prevention Study

doi:10.1111/ppe.12075

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Maternal periconceptional exposure to cigarette smoking and congenital limb deficiencies

Journal article

Peer reviewed

Maternal periconceptional exposure to cigarette smoking and congenital limb deficiencies

Kristin M Caspers, Paul A Romitti, Shao Lin, Richard S Olney, Lewis B Holmes, Martha M Werler and National Birth Defects Prevention Study

Paediatric and perinatal epidemiology, Vol.27(6), pp.509-520

11/2013

DOI: 10.1111/ppe.12075

PMCID: PMC4445653

PMID: 24134526

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Abstract

Congenital limb deficiencies (LD)s are characterised by the failure or disruption in formation of limbs or digits. Epidemiological research on maternal exposure to cigarette smoke and LDs is inconclusive. Data from the National Birth Defects Prevention Study were used to examine LDs and maternal exposure to active or passive cigarette smoke. Mothers of LD case (n = 906) and unaffected control (n = 8352) pregnancies from October 1997 through December 2007 reported on exposure type and quantity. Logistic regression was used to estimate adjusted odds ratio (OR) and 95% confidence interval [95% CI]; interactions with folic acid (FA) intake were tested. For any LD, ORs were elevated for active (1.24 [95% CI 1.01, 1.53]), passive (home) (1.28 [95% CI 1.03, 1.59]), and 'active and passive' (1.34 [95% CI 1.05, 1.70]) exposures. The ORs for longitudinal LDs were elevated for passive (home) (1.62 [95% CI 1.14, 2.31]) and 'active and passive' (1.62 [95% CI 1.09, 2.41]) exposures. The OR for pre-axial LDs were elevated for any (1.39 [95% CI 1.01, 1.90]), active (1.53 [95% CI 1.03, 2.29]), passive (home) (1.82 [95% CI 1.23, 2.69]), and 'active and passive' (1.87 [95% CI 1.20, 2.92]) exposures. For lower limbs, ORs were elevated for passive (home) (1.44 [95% CI 1.01, 2.04]) and smoking 15 or more cigarettes/day (2.25 [95% CI 1.27, 3.97]). Interactions showed that ORs for any passive smoke exposure were 0.43 and 0.59 higher in the absence of FA intake for any and terminal transverse LDs. Maternal active smoking and exposure to passive cigarette smoke emerged as a potential teratogen that affects limb and digit formation. FA was not found to mitigate the impact.

United States

Pregnancy

Smoking - adverse effects

Prenatal Exposure Delayed Effects - epidemiology

Humans

Risk Factors

Logistic Models

Male

Case-Control Studies

Young Adult

Tobacco Smoke Pollution - adverse effects

Limb Deformities, Congenital - etiology

Maternal Exposure - adverse effects

Adult

Female

Odds Ratio

Infant, Newborn

Details

Title: Subtitle: Maternal periconceptional exposure to cigarette smoking and congenital limb deficiencies
Creators: Kristin M Caspers - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA
Paul A Romitti
Shao Lin
Richard S Olney
Lewis B Holmes
Martha M Werler
National Birth Defects Prevention Study
Resource Type: Journal article
Publication Details: Paediatric and perinatal epidemiology, Vol.27(6), pp.509-520
Publisher: England
DOI: 10.1111/ppe.12075
PMID: 24134526
PMCID: PMC4445653
ISSN: 0269-5022
eISSN: 1365-3016
Grant note: U01 DD000492 / NCBDD CDC HHS P30 ES005605 / NIEHS NIH HHS CC999999 / Intramural CDC HHS U01DD000492 / NCBDD CDC HHS U01 DD001035 / NCBDD CDC HHS
Language: English
Date published: 11/2013
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9983995134102771

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