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, New York, USA.
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
Birth Defects Res. 2024 Dec;116(12):e2420. doi: 10.1002/bdr2.2420.
Previous studies of maternal alcohol consumption and craniosynostosis have reported null or inverse associations. We updated a previous analysis of National Birth Defects Prevention Study (NBDPS) data to further examine associations between maternal alcohol consumption and craniosynostosis.
NBDPS was a multi-site, population-based case-control study. Mothers of craniosynostosis cases and randomly selected liveborn controls delivered during 1997-2011 completed a telephone interview about pregnancy exposures. We examined associations for self-reported periconceptional maternal alcohol consumption (during the month before conception through the third gestational month) and odds of craniosynostosis in offspring. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between any alcohol consumption and binge consumption and craniosynostosis, overall and by affected suture. Finally, we performed a probabilistic bias analysis using a range of assumptions about the sensitivity and specificity of self-reported consumption by case/control status.
We analyzed interview data from 1435 mothers of craniosynostosis cases and 11,216 mothers of controls. Periconceptional alcohol consumption prevalence was similar among case (36.9%) and control (38.2%) mothers. We observed point estimates near or below 1.0 for alcohol consumption (any and binge) and all suture subtypes of craniosynostosis, with all CIs including the null. Our bias-adjusted estimates for periconceptional alcohol consumption were higher than our conventional estimates but supported the null findings.
We observed primarily null associations between maternal periconceptional alcohol consumption and craniosynostosis. However, our findings do not diminish the prevailing clinical guidance in the United States that pregnant people should abstain from alcohol consumption.
既往关于孕期母亲饮酒与颅缝早闭的研究报告了无关联或负相关。我们更新了之前对国家出生缺陷预防研究(NBDPS)数据的分析,以进一步研究孕期母亲饮酒与颅缝早闭之间的关联。
NBDPS是一项基于人群的多中心病例对照研究。颅缝早闭病例的母亲以及1997年至2011年期间随机选取的活产对照的母亲完成了关于孕期暴露情况的电话访谈。我们研究了自我报告的受孕前母亲饮酒情况(受孕前一个月至妊娠第三个月期间)与后代患颅缝早闭的几率之间的关联。我们使用逻辑回归来估计任何饮酒量和暴饮与颅缝早闭之间关联的比值比(OR)和95%置信区间(CI),总体以及按受影响的缝线进行分析。最后,我们使用一系列关于病例/对照状态下自我报告饮酒的敏感性和特异性的假设进行概率偏差分析。
我们分析了1435例颅缝早闭病例的母亲和11216例对照的母亲的访谈数据。病例组母亲(36.9%)和对照组母亲(38.2%)的受孕前饮酒患病率相似。我们观察到饮酒量(任何饮酒量和暴饮)与颅缝早闭的所有缝线亚型的点估计值接近或低于1.0,所有置信区间均包含无效值。我们对受孕前饮酒的偏差调整估计值高于传统估计值,但仍支持无关联的结果。
我们观察到孕期母亲饮酒与颅缝早闭之间主要无关联。然而,我们的研究结果并未削弱美国现行的临床指南,即孕妇应戒酒。