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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
url
http://doi.org/10.1111/ppe.12075View
Open Access

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

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