Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study

Background Congenital heart diseases (CHDs) are the most common congenital anomaly. The causes of CHDs are largely unknown. Higher prenatal body mass index (BMI), smoking, and alcohol consumption are associated with increased risk of CHDs. Whether these are causal is unclear. Methods and Results Sev...

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Main Authors: Kurt Taylor, Ahmed Elhakeem, Johanna Lucia Thorbjørnsrud Nader, Tiffany C. Yang, Elena Isaevska, Lorenzo Richiardi, Tanja Vrijkotte, Angela Pinot de Moira, Deirdre M. Murray, Daragh Finn, Dan Mason, John Wright, Sam Oddie, Nel Roeleveld, Jennifer R. Harris, Anne‐Marie Nybo Andersen, Massimo Caputo, Deborah A. Lawlor
Format: Article
Language:English
Published: Wiley 2021-06-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.120.020051
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author Kurt Taylor
Ahmed Elhakeem
Johanna Lucia Thorbjørnsrud Nader
Tiffany C. Yang
Elena Isaevska
Lorenzo Richiardi
Tanja Vrijkotte
Angela Pinot de Moira
Deirdre M. Murray
Daragh Finn
Dan Mason
John Wright
Sam Oddie
Nel Roeleveld
Jennifer R. Harris
Anne‐Marie Nybo Andersen
Massimo Caputo
Deborah A. Lawlor
spellingShingle Kurt Taylor
Ahmed Elhakeem
Johanna Lucia Thorbjørnsrud Nader
Tiffany C. Yang
Elena Isaevska
Lorenzo Richiardi
Tanja Vrijkotte
Angela Pinot de Moira
Deirdre M. Murray
Daragh Finn
Dan Mason
John Wright
Sam Oddie
Nel Roeleveld
Jennifer R. Harris
Anne‐Marie Nybo Andersen
Massimo Caputo
Deborah A. Lawlor
Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
congenital heart disease
negative control
risk factors
author_facet Kurt Taylor
Ahmed Elhakeem
Johanna Lucia Thorbjørnsrud Nader
Tiffany C. Yang
Elena Isaevska
Lorenzo Richiardi
Tanja Vrijkotte
Angela Pinot de Moira
Deirdre M. Murray
Daragh Finn
Dan Mason
John Wright
Sam Oddie
Nel Roeleveld
Jennifer R. Harris
Anne‐Marie Nybo Andersen
Massimo Caputo
Deborah A. Lawlor
author_sort Kurt Taylor
title Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study
title_short Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study
title_full Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study
title_fullStr Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study
title_full_unstemmed Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study
title_sort effect of maternal prepregnancy/early‐pregnancy body mass index and pregnancy smoking and alcohol on congenital heart diseases: a parental negative control study
publisher Wiley
series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
issn 2047-9980
publishDate 2021-06-01
description Background Congenital heart diseases (CHDs) are the most common congenital anomaly. The causes of CHDs are largely unknown. Higher prenatal body mass index (BMI), smoking, and alcohol consumption are associated with increased risk of CHDs. Whether these are causal is unclear. Methods and Results Seven European birth cohorts, including 232 390 offspring (2469 CHD cases [1.1%]), were included. We applied negative exposure paternal control analyses to explore the intrauterine effects of maternal BMI, smoking, and alcohol consumption during pregnancy, on offspring CHDs and CHD severity. We used logistic regression, adjusting for confounders and the other parent's exposure and combined estimates using a fixed‐effects meta‐analysis. In adjusted analyses, maternal overweight (odds ratio [OR], 1.15 [95% CI, 1.01–1.31]) and obesity (OR, 1.12 [95% CI, 0.93–1.36]), compared with normal weight, were associated with higher odds of CHD, but there was no clear evidence of a linear increase in odds across the whole BMI distribution. Associations of paternal overweight, obesity, and mean BMI were similar to the maternal associations. Maternal pregnancy smoking was associated with higher odds of CHD (OR, 1.11 [95% CI, 0.97–1.25]) but paternal smoking was not (OR, 0.96 [95% CI, 0.85–1.07]). The positive association with maternal smoking appeared to be driven by nonsevere CHD cases (OR, 1.22 [95% CI, 1.04–1.44]). Associations with maternal moderate/heavy pregnancy alcohol consumption were imprecisely estimated (OR, 1.16 [95% CI, 0.52–2.58]) and similar to those for paternal consumption. Conclusions We found evidence of an intrauterine effect for maternal smoking on offspring CHDs, but no evidence for higher maternal BMI or alcohol consumption. Our findings provide further support for the importance of smoking cessation during pregnancy.
topic congenital heart disease
negative control
risk factors
url https://www.ahajournals.org/doi/10.1161/JAHA.120.020051
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spelling doaj-66c6e07218b244ff91ddbfac8c163c512021-09-14T15:27:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-06-01101110.1161/JAHA.120.020051Effect of Maternal Prepregnancy/Early‐Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control StudyKurt Taylor0Ahmed Elhakeem1Johanna Lucia Thorbjørnsrud Nader2Tiffany C. Yang3Elena Isaevska4Lorenzo Richiardi5Tanja Vrijkotte6Angela Pinot de Moira7Deirdre M. Murray8Daragh Finn9Dan Mason10John Wright11Sam Oddie12Nel Roeleveld13Jennifer R. Harris14Anne‐Marie Nybo Andersen15Massimo Caputo16Deborah A. Lawlor17Population Health Science Bristol Medical School Bristol United KingdomPopulation Health Science Bristol Medical School Bristol United KingdomDivision of Health Data and Digitalisation Department of Genetics and Bioinformatics Norwegian Institute of Public Health Oslo NorwayBradford Institute for Health ResearchBradford Teaching Hospitals National Health Service Foundation Trust Bradford United KingdomCancer Epidemiology Unit Department of Medical Sciences University of Turin and CPO Piemonte Turin ItalyCancer Epidemiology Unit Department of Medical Sciences University of Turin and CPO Piemonte Turin ItalyDepartment of Public and Occupational Health Amsterdam Public Health Research Institute Amsterdam University Medical CenterUniversity of Amsterdam the NetherlandsSection for Epidemiology Department of Public Health University of Copenhagen DenmarkThe Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork IrelandThe Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork IrelandBradford Institute for Health ResearchBradford Teaching Hospitals National Health Service Foundation Trust Bradford United KingdomBradford Institute for Health ResearchBradford Teaching Hospitals National Health Service Foundation Trust Bradford United KingdomCentre for Reviews and Dissemination University of York Heslington York United KingdomDepartment for Health Evidence Radboud Institute for Health SciencesRadboud University Medical Center Nijmegen the NetherlandsDivision of Health Data and Digitalisation Norwegian Institute of Public Health Oslo NorwaySection for Epidemiology Department of Public Health University of Copenhagen DenmarkTranslational Science Bristol Medical School Bristol United KingdomPopulation Health Science Bristol Medical School Bristol United KingdomBackground Congenital heart diseases (CHDs) are the most common congenital anomaly. The causes of CHDs are largely unknown. Higher prenatal body mass index (BMI), smoking, and alcohol consumption are associated with increased risk of CHDs. Whether these are causal is unclear. Methods and Results Seven European birth cohorts, including 232 390 offspring (2469 CHD cases [1.1%]), were included. We applied negative exposure paternal control analyses to explore the intrauterine effects of maternal BMI, smoking, and alcohol consumption during pregnancy, on offspring CHDs and CHD severity. We used logistic regression, adjusting for confounders and the other parent's exposure and combined estimates using a fixed‐effects meta‐analysis. In adjusted analyses, maternal overweight (odds ratio [OR], 1.15 [95% CI, 1.01–1.31]) and obesity (OR, 1.12 [95% CI, 0.93–1.36]), compared with normal weight, were associated with higher odds of CHD, but there was no clear evidence of a linear increase in odds across the whole BMI distribution. Associations of paternal overweight, obesity, and mean BMI were similar to the maternal associations. Maternal pregnancy smoking was associated with higher odds of CHD (OR, 1.11 [95% CI, 0.97–1.25]) but paternal smoking was not (OR, 0.96 [95% CI, 0.85–1.07]). The positive association with maternal smoking appeared to be driven by nonsevere CHD cases (OR, 1.22 [95% CI, 1.04–1.44]). Associations with maternal moderate/heavy pregnancy alcohol consumption were imprecisely estimated (OR, 1.16 [95% CI, 0.52–2.58]) and similar to those for paternal consumption. Conclusions We found evidence of an intrauterine effect for maternal smoking on offspring CHDs, but no evidence for higher maternal BMI or alcohol consumption. Our findings provide further support for the importance of smoking cessation during pregnancy.https://www.ahajournals.org/doi/10.1161/JAHA.120.020051congenital heart diseasenegative controlrisk factors