Zhang Senmao, Wang Lesan, Yang Tubao, Chen Lizhang, Zhao Lijuan, Wang Tingting, Chen Letao, Ye Ziwei, Zheng Zan, Qin Jiabi
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China.
Eur J Prev Cardiol. 2020 Mar;27(4):410-421. doi: 10.1177/2047487319874530. Epub 2019 Oct 2.
The aim of this study was to provide updated evidence to assess the association between parental alcohol consumption and the risk of total congenital heart diseases (CHDs) and specific CHD phenotypes in offspring, and explore the possible dose-response pattern.
PubMed, Embase and Chinese databases were searched with an end-date parameter of July 24, 2019 to identify studies meeting pre-stated inclusion criteria. A random-effects model was used to calculate the overall combined risk estimates. A meta-analysis of the dose-response relationship was performed. Subgroup analysis, sensitivity analysis, and Galbraith plot were conducted to explore potential heterogeneity moderators.
A total of 55 studies involving 41,747 CHD cases and 297,587 controls were identified. Overall, both maternal (odds ratio (OR) = 1.16; 95% confidence interval (CI): 1.05-1.27) and paternal (OR = 1.44; 95% CI: 1.19-1.74) alcohol exposures were significantly associated with risk of total CHDs in offspring. Additionally, a nonlinear dose-response relationship between parental alcohol exposure and risk of total CHDs was observed. With an increase in parental alcohol consumption, the risk of total CHDs in offspring also gradually increases. For specific CHD phenotypes, a statistically significant association was found between maternal alcohol consumption and risk of tetralogy of fallot (OR = 1.20; 95% CI: 1.08-1.33). Relevant heterogeneity moderators have been identified by subgroup analysis, and sensitivity analysis yielded consistent results.
Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, our review indicates that parental alcohol exposures are significantly associated with the risk of CHDs in offspring, which highlights the necessity of improving health awareness to prevent alcohol exposure during preconception and conception periods.
本研究旨在提供最新证据，以评估父母饮酒与子代患先天性心脏病（CHD）及特定CHD表型风险之间的关联，并探讨可能的剂量反应模式。
检索PubMed、Embase和中文数据库，检索截止日期为2019年7月24日，以确定符合预先设定纳入标准的研究。采用随机效应模型计算总体合并风险估计值。对剂量反应关系进行荟萃分析。进行亚组分析、敏感性分析和Galbraith图分析，以探索潜在的异质性调节因素。
共纳入55项研究，涉及41747例CHD病例和297587例对照。总体而言，母亲（比值比（OR）=1.16；95%置信区间（CI）：1.05-1.27）和父亲（OR=1.44；95%CI：1.19-1.74）饮酒均与子代患CHD的风险显著相关。此外，观察到父母饮酒与子代患CHD风险之间存在非线性剂量反应关系。随着父母饮酒量的增加，子代患CHD的风险也逐渐增加。对于特定的CHD表型，发现母亲饮酒与法洛四联症风险之间存在统计学显著关联（OR=1.20；95%CI：1.08-1.33）。通过亚组分析确定了相关的异质性调节因素，敏感性分析得出了一致的结果。
尽管应仔细评估潜在偏倚的作用和异质性证据，但我们的综述表明，父母饮酒与子代患CHD的风险显著相关，这凸显了提高健康意识以预防孕前和孕期酒精暴露的必要性。
