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母亲饮酒与先天畸形后代风险:日本环境与儿童研究。

Maternal alcohol consumption and risk of offspring with congenital malformation: the Japan Environment and Children's Study.

机构信息

Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

出版信息

Pediatr Res. 2021 Aug;90(2):479-486. doi: 10.1038/s41390-020-01274-9. Epub 2020 Nov 23.

Abstract

BACKGROUND

The association between fetal exposure to alcohol and congenital structural disorders remains inconclusive. The present study searched for relationships between maternal alcohol consumption during pregnancy and the risk of congenital malformations.

METHODS

We evaluated the fixed dataset of a large national birth cohort study including 73,595 mothers with a singleton live birth. Information regarding the alcohol consumption of mothers was obtained from self-reported questionnaires. Physicians assessed for 6 major congenital malformations (congenital heart defects [CHDs], male genital abnormalities, limb defects, cleft lip and/or cleft palate [orofacial clefts (OFC)], severe brain abnormalities, and gastrointestinal obstructions) up to 1 month after birth. Multiple logistic regression analysis was performed to identify associations between maternal alcohol consumption during pregnancy and each malformation.

RESULTS

The prevalence of maternal drinking in early pregnancy and until the second/third trimester was 46.6% and 2.8%, respectively. The onset of CHD was inversely associated with mothers who quit drinking during early pregnancy (OR 0.85, 95% CI 0.74-0.98). There was no remarkable impact of maternal drinking habit status on the other congenital malformations after adjustment for covariates.

CONCLUSIONS

Maternal alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital malformations of interest.

IMPACT

This large-scale Japanese cohort study revealed that no teratogenic associations were found between maternal retrospective reports of periconceptional alcohol consumption and congenital malformations after adjustment for covariates. This is the first nationwide birth cohort study in Japan to assess the effect of maternal alcohol consumption during pregnancy on major congenital malformations. Our finding indicated that maternal low-to-moderate alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital heart defects, male genital abnormalities, limb defects, orofacial clefts, severe brain abnormalities, or gastrointestinal obstructions.

摘要

背景

胎儿暴露于酒精与先天性结构异常之间的关联仍不确定。本研究旨在寻找母亲怀孕期间饮酒与先天性畸形风险之间的关系。

方法

我们评估了一项大型全国性出生队列研究的固定数据集,该研究纳入了 73595 名单胎活产母亲。母亲饮酒信息来自于自我报告的调查问卷。医生在出生后 1 个月内评估了 6 种主要的先天性畸形(先天性心脏病[CHD]、男性生殖器异常、肢体缺陷、唇裂和/或腭裂[唇腭裂(OFC)]、严重脑异常和胃肠道梗阻)。采用多因素逻辑回归分析来确定母亲怀孕期间饮酒与每种畸形之间的关联。

结果

母亲在孕早期和妊娠中期至晚期的饮酒率分别为 46.6%和 2.8%。CHD 的发病与母亲在孕早期戒酒相关(OR 0.85,95%CI 0.74-0.98)。调整了协变量后,母亲饮酒习惯状况对其他先天性畸形没有明显影响。

结论

母亲怀孕期间饮酒,即使是在孕早期,也不会对所关注的先天性畸形产生显著的不良影响。

意义

这项大规模的日本队列研究表明,在调整了协变量后,母亲围孕期回顾性饮酒报告与先天性畸形之间没有发现明显的致畸关联。这是日本首例评估母亲怀孕期间饮酒对主要先天性畸形影响的全国性出生队列研究。我们的研究结果表明,母亲在怀孕期间低至中度饮酒,即使是在孕早期,也不会对先天性心脏病、男性生殖器异常、肢体缺陷、唇腭裂、严重脑异常或胃肠道梗阻产生显著的不良影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8629/8460444/0ada6317715e/41390_2020_1274_Fig1_HTML.jpg

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