Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
National Health Commission Key Laboratory for Birth Defect Research and Prevention, Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China.
Birth Defects Res. 2021 Jul 15;113(12):883-893. doi: 10.1002/bdr2.1823. Epub 2020 Oct 17.
The present study aimed at providing some epidemiological evidences to assess the association of paternal smoking with the risk of neural tube defects (NTDs) and its specific subtypes in offspring, and explore the possible dose-response relationship between paternal smoking and risk of NTDs.
English and Chinese databases were systematically searched from 1984 to May 2020. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. We also examined the dose-response relationship between parental smoking and risk of NTDs in offspring. Subgroup analyses and sensitivity analyses were conducted to explore possible sources of heterogeneity.
A total of 10 case-control studies involving 2,593 cases of NTDs and 45,100 controls were included for analysis. Findings from our study showed that paternal smoking was significantly associated with risk of total NTDs (odds ratio [OR] = 1.68; 95% confidence interval (CI): 1.48-1.92) and two subtypes including anencephaly (OR = 1.41; 95% CI: 1.06-1.86) and encephaloceles (OR = 2.90; 95% CI: 1.00-8.41). Additionally, a linear dose-response relationship between paternal smoking and risk of NTDs was observed, which indicated that the risk of NTDs in offspring was significantly increased by 45% (OR = 1.45, 95% CI: 1.14-1.84) for each increment of half a pack of cigarettes per day. Sensitivity analyses yielded consistent results. No evidence of publication bias was found.
Paternal smoking is significantly associated with the risk of NTDs in offspring. Therefore, it should be recommended that fathers quit smoking before pregnancy to prevent NTDs in offspring.
本研究旨在提供一些流行病学证据，以评估父亲吸烟与子女神经管缺陷（NTDs）风险及其特定亚型之间的关联，并探讨父亲吸烟与 NTDs 风险之间可能存在的剂量-反应关系。
系统检索了 1984 年至 2020 年 5 月的英文和中文数据库。使用固定效应或随机效应模型计算总体合并风险估计值。我们还检查了父母吸烟与子女 NTDs 风险之间的剂量-反应关系。进行亚组分析和敏感性分析以探索可能存在的异质性来源。
共有 10 项病例对照研究纳入了 2593 例 NTDs 病例和 45100 例对照进行分析。本研究结果表明，父亲吸烟与 NTDs 总风险显著相关（比值比 [OR] = 1.68；95%置信区间 [CI]：1.48-1.92）和两个亚型包括无脑畸形（OR = 1.41；95% CI：1.06-1.86）和脑膨出（OR = 2.90；95% CI：1.00-8.41）。此外，还观察到父亲吸烟与 NTDs 风险之间存在线性剂量-反应关系，这表明，与每天吸烟半包以下相比，每天吸烟半包以上，子女患 NTDs 的风险显著增加 45%（OR = 1.45，95% CI：1.14-1.84）。敏感性分析得出了一致的结果。未发现发表偏倚的证据。
父亲吸烟与子女 NTDs 风险显著相关。因此，建议父亲在怀孕前戒烟，以预防子女患 NTDs。
