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Maternal Periconceptional Exposure to Cigarette Smoking and Congenital Limb Deficiencies
Author(s) -
Caspers Kristin M.,
Romitti Paul A.,
Lin Shao,
Olney Richard S.,
Holmes Lewis B.,
Werler Martha M.
Publication year - 2013
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12075
Subject(s) - medicine , passive smoking , odds ratio , confidence interval , pregnancy , cigarette smoke , epidemiology , logistic regression , environmental health , genetics , biology
Abstract Background Congenital limb deficiencies ( LD )s are characterised by the failure or disruption in formation of limbs or digits. Epidemiological research on maternal exposure to cigarette smoke and LDs is inconclusive. Methods Data from the N ational B irth D efects P revention S tudy were used to examine LDs and maternal exposure to active or passive cigarette smoke. Mothers of LD case ( n = 906) and unaffected control ( n = 8352) pregnancies from O ctober 1997 through D ecember 2007 reported on exposure type and quantity. Logistic regression was used to estimate adjusted odds ratio ( OR ) and 95% confidence interval [95% CI ]; interactions with folic acid ( FA ) intake were tested. Results For any LD , OR s were elevated for active (1.24 [95% CI 1.01, 1.53]), passive (home) (1.28 [95% CI 1.03, 1.59]), and ‘active and passive’ (1.34 [95% CI 1.05, 1.70]) exposures. The OR s for longitudinal LDs were elevated for passive (home) (1.62 [95% CI 1.14, 2.31]) and ‘active and passive’ (1.62 [95% CI 1.09, 2.41]) exposures. The OR for pre‐axial LDs were elevated for any (1.39 [95% CI 1.01, 1.90]), active (1.53 [95% CI 1.03, 2.29]), passive (home) (1.82 [95% CI 1.23, 2.69]), and ‘active and passive’ (1.87 [95% CI 1.20, 2.92]) exposures. For lower limbs, ORs were elevated for passive (home) (1.44 [95% CI 1.01, 2.04]) and smoking 15 or more cigarettes/day (2.25 [95% CI 1.27, 3.97]). Interactions showed that ORs for any passive smoke exposure were 0.43 and 0.59 higher in the absence of FA intake for any and terminal transverse LDs . Conclusions Maternal active smoking and exposure to passive cigarette smoke emerged as a potential teratogen that affects limb and digit formation. FA was not found to mitigate the impact.