Fisher Sarah C, Romitti Paul A, Tracy Melissa, Howley Meredith M, Jabs Ethylin Wang, Browne Marilyn L
Birth Defects Registry, New York State Department of Health, Albany, NY, United States.
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States.
Prev Med. 2024 Mar;180:107891. doi: 10.1016/j.ypmed.2024.107891. Epub 2024 Feb 9.
Previous studies of alcohol consumption during pregnancy and omphalocele have produced mixed results. We updated an earlier analysis of National Birth Defects Prevention Study (NBDPS) data, adding six years of participants, to examine associations between maternal alcohol consumption and omphalocele.
NBDPS was a multi-site, population-based case-control study in the United States. Cases were identified from birth defect surveillance programs in 10 states; controls were liveborn infants without a birth defect randomly selected from the same catchment areas. Mothers self-reported alcohol consumption during the periconceptional period (one month before through the third gestational month) via telephone interview. Our study included mothers of 410 omphalocele cases and 11,219 controls with estimated dates of delivery (EDDs) during 1997-2011. We used logistic regression to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for periconceptional alcohol consumption and omphalocele. We performed a probabilistic bias analysis to evaluate the impact of alcohol exposure misclassification on our results.
Overall, 44% of case and 38% of control mothers reported periconceptional alcohol consumption; 22% and 17%, respectively, reported binge drinking. Any maternal periconceptional alcohol consumption was associated with modestly increased odds of omphalocele (AOR 1.35, 95% CI 1.09, 1.68), as was binge drinking (AOR 1.47, 95% CI 1.08, 2.01). Our bias analysis yielded estimates further from the null.
We observed modest associations between maternal periconceptional alcohol consumption and omphalocele. Based on our bias analysis, studies of alcohol and birth defects not accounting for exposure misclassification may underestimate associations.
先前关于孕期饮酒与腹裂的研究结果不一。我们更新了一项对国家出生缺陷预防研究（NBDPS）数据的早期分析，增加了六年的参与者数据，以研究孕妇饮酒与腹裂之间的关联。
NBDPS是美国一项基于人群的多中心病例对照研究。病例来自10个州的出生缺陷监测项目；对照是从相同集水区随机选取的无出生缺陷的活产婴儿。母亲们通过电话访谈自我报告受孕前时期（受孕前一个月至妊娠第三个月）的饮酒情况。我们的研究纳入了1997 - 2011年期间410例腹裂病例的母亲和11219例对照母亲，她们均有预计分娩日期（EDD）。我们使用逻辑回归来估计受孕前饮酒与腹裂的调整优势比（AOR）和95%置信区间（CI）。我们进行了概率偏差分析，以评估饮酒暴露错误分类对我们结果的影响。
总体而言，44%的病例母亲和38%的对照母亲报告在受孕前饮酒；分别有22%和17%报告有暴饮情况。母亲在受孕前任何饮酒情况都与腹裂几率适度增加相关（AOR 1.35，95% CI 1.09，1.68），暴饮情况也是如此（AOR 1.47，95% CI 1.08，2.01）。我们的偏差分析得出离无效值更远的估计值。
我们观察到母亲受孕前饮酒与腹裂之间存在适度关联。基于我们的偏差分析，未考虑暴露错误分类的酒精与出生缺陷研究可能低估了这种关联。
