Division of Neonatology and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Birth Defects Res. 2017 Aug 15;109(14):1127-1133. doi: 10.1002/bdr2.1044. Epub 2017 Jun 21.
We examined the association of hypospadias risk with maternal smoking and consumption of alcohol and caffeine.
We analyzed data from mothers of 2437 moderate/severe cases and 5472 nonmalformed controls born from 1997 to 2011 who participated in the National Birth Defects Prevention Study (NBDPS). Exposures were assessed by maternal telephone interviews. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for mother's age, parity, race-ethnicity, education, vitamin/mineral supplement intake, obesity, and study center.
Active smoking during the first month of pregnancy was associated with reduced risk, with smaller ORs for increasing quantity smoked; the OR for smoking >1/2 pack/day was 0.7 (95% CI, 0.5-0.9). Among nonsmokers, the OR for any secondhand smoke exposure was 0.8 (95% CI, 0.7-0.9). ORs for alcohol and caffeine consumption were near one and CIs included 1.0. In an analysis of joint exposures to smoking and alcohol and caffeine consumption, the only OR for which the 95% CI excluded 1.0 was for women who smoked, drank, and had low caffeine consumption (OR, 0.6; 95% CI, 0.4-0.8).
Maternal exposure to cigarette smoke was associated with reduced risk, and women who smoked, drank, and had low caffeine intake were at lowest risk. We do not interpret these results to suggest that these exposures have overall benefit to a pregnant woman or developing fetus. They may, however, offer clues to help us understand mechanisms that lead to hypospadias. Birth Defects Research 109:1127-1133, 2017. © 2017 Wiley Periodicals, Inc.
我们研究了母亲吸烟、饮酒和咖啡因摄入与尿道下裂风险的关系。
我们分析了 1997 年至 2011 年间参与国家出生缺陷预防研究（NBDPS）的 2437 例中重度病例和 5472 例非畸形对照母亲的数据。通过母亲的电话访谈评估暴露情况。使用 logistic 回归估计调整母亲年龄、产次、种族、教育程度、维生素/矿物质补充剂摄入、肥胖和研究中心后，比值比（OR）和 95%置信区间（95%CI）。
妊娠第一个月主动吸烟与风险降低相关，吸烟量增加时 OR 越小；每天吸烟>1/2 包的 OR 为 0.7（95%CI，0.5-0.9）。在不吸烟者中，任何二手烟暴露的 OR 为 0.8（95%CI，0.7-0.9）。酒精和咖啡因摄入的 OR 接近 1，CI 包含 1.0。在对吸烟和酒精及咖啡因摄入联合暴露的分析中，唯一的 95%CI 不包括 1.0 的 OR 是吸烟、饮酒且咖啡因摄入低的女性（OR，0.6；95%CI，0.4-0.8）。
母亲暴露于香烟烟雾与风险降低相关，而吸烟、饮酒且咖啡因摄入低的女性风险最低。我们不解释这些结果表明这些暴露对孕妇或发育中的胎儿有整体益处。然而，它们可能为帮助我们理解导致尿道下裂的机制提供线索。出生缺陷研究 109:1127-1133, 2017. © 2017 Wiley Periodicals, Inc.
