Abstract：Objective To study the association between maternal alcohol consumption and the risk of congenital heart disease (CHD) in offspring. Methods PubMed, Cochrane Library, Web of Science, Google Scholar, China Biology Medicine disc, Wanfang Database, CNKI Database, and Weipu Database were searched for the articles on the association between maternal alcohol consumption and congenital heart disease in offspring. These articles were published up to November 30, 2019. A random effects model or a fixed effects model was used for the pooled analysis of the results of each study, and then the pooled effective value and its 95%CI were calculated. A subgroup analysis was performed to explore heterogeneous regulators. Funnel plots and an Egger's test were used to assess publication bias. Results A total of 4 409 articles were searched, and 55 articles were finally included in this analysis, among which there were 6 cohort studies and 49 case-control studies. The Meta analysis showed heterogeneity across all studies (I2=74%, P < 0.01). The random effects model showed that maternal alcohol consumption was associated with CHD in offspring, with an OR of 1.18 (95%CI:1.09-1.28). The Egger's test showed a certain degree of publication bias (P < 0.05), and after adjustment, the pooled OR of CHD in offspring was 1.10 (95%CI:1.01-1.21). Conclusions Maternal alcohol consumption may increase the risk of CHD in offspring.
LI Qi,YAO Hua,GU Guan-Jun et al. Association between maternal alcohol consumption and risk of congenital heart disease in offspring: a Meta analysis[J]. CJCP, 2020, 22(6): 643-650.
Yu Z, Xi Y, Ding W, et al. Congenital heart disease in a Chinese hospital:pre- and postnatal detection, incidence, clinical characteristics and outcomes[J]. Pediatr Int, 2011, 53(6):1059-1065.
van der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide:a systematic review and meta-analysis[J]. J Am Coll Cardiol, 2011, 58(21):2241-2247.
Begić H, Tahirović HF, Dinarević S, et al. Risk factors for the development of congenital heart defects in children born in the Tuzla Canton[J]. Med Arh, 2002, 56(2):73-77.
Liu C, Lodge J, Flatley C, et al. Obstetric and perinatal outcomes in pregnancies with isolated foetal congenital heart abnormalities[J]. J Matern Fetal Neonatal Med, 2019, 32(18):2985-2992.
[10]
O'Leary CM, Elliottet EJ, Nassar N, et al. Exploring the potential to use data linkage for investigating the relationship between birth defects and prenatal alcohol exposure[J]. Birth Defects Res A Clin Mol Teratol, 2013, 97(7):497-504.
[11]
Strandberg-Larsen K, Skov-Ettrup LS, Grønbaek M, et al. Maternal alcohol drinking pattern during pregnancy and the risk for an offspring with an isolated congenital heart defect and in particular a ventricular septal defect or an atrial septal defect[J]. Birth Defects Res A Clin Mol Teratol, 2011, 91(7):616-622.
[12]
Zhu Y, Romitti PA, Caspers-Conway KM, et al. Maternal periconceptional alcohol consumption and congenital heart defects[J]. Birth Defects Res A Clin Mol Teratol, 2015, 103(7):617-629.
Boneva RS, Moore CA, Botto L, et al. Nausea during pregnancy and congenital heart defects:a population-based case-control study[J]. Am J Epidemiol, 1999, 149(8):717-725.
Carmichael SL, Shaw GM, Yang W, et al. Maternal periconceptional alcohol consumption and risk for conotruncal heart defects[J]. Birth Defects Res A Clin Mol Teratol, 2003, 67(10):875-878.
[17]
Cedergren MI, Selbing AJ, Källén BA. Risk factors for cardiovascular malformation-a study based on prospectively collected data[J]. Scand J Work Environ Health, 2002, 28(1):12-17.
[18]
Ewing CK, Loffredo CA, Beaty TH. Paternal risk factors for isolated membranous ventricular septal defects[J]. Am J Med Genet, 1997, 71(1):42-46.
[19]
Feng Y, Cai J, Tong X, et al. Non-inheritable risk factors during pregnancy for congenital heart defects in offspring:a matched case-control study[J]. Int J Cardiol, 2018, 264:45-52.
[20]
Gong W, Liang Q, Zheng D, et al. Congenital heart defects of fetus after maternal exposure to organic and inorganic environmental factors:a cohort study[J]. Oncotarget, 2017, 8(59):100717-100723.
[21]
Grewal J, Carmichael SL, Ma C, et al. Maternal periconceptional smoking and alcohol consumption and risk for select congenital anomalies[J]. Birth Defects Res A Clin Mol Teratol, 2008, 82(7):519-526.
[22]
Hobbs CA, James SJ, Jernigan S, et al. Congenital heart defects, maternal homocysteine, smoking, and the 677 C>T polymorphism in the methylenetetrahydrofolate reductase gene:evaluating gene-environment interactions[J]. Am J Obstet Gynecol, 2006, 194(1):218-224.
[23]
Hobbs CA, Cleves MA, Karim MA, et al. Maternal folate-related gene environment interactions and congenital heart defects[J]. Obstet Gynecol, 2010, 116(2):316-322.
[24]
Kuciene R, Dulskiene V. Maternal socioeconomic and lifestyle factors during pregnancy and the risk of congenital heart defects[J]. Medicina (Kaunas), 2009, 45(11):904-909.
[25]
Malik S, Cleves MA, Honein MA, et al. Maternal smoking and congenital heart defects[J]. Pediatrics, 2008, 121(4):e810-e816.
[26]
Mateja WA, Nelson DB, Kroelinger CD, et al. The association between maternal alcohol use and smoking in early pregnancy and congenital cardiac defects[J]. J Women Health (Larchmt), 2012, 21(1):26-34.
[27]
McDonald AD, Armstrong BG, Sloan M. Cigarette, alcohol, and coffee consumption and congenital defects[J]. Am J Public Health, 1992, 82(1):91-93.
[28]
Mills JL, Troendle J, Conley MR, et al. Maternal obesity and congenital heart defects:a population-based study[J]. Am J Clin Nutr, 2010, 91(6):1543-1549.
[29]
Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring[J]. BJOG, 2009, 116(3):416-423.
[30]
Steinberger EK, Ferencz C, Loffredo CA. Infants with single ventricle:a population-based epidemiological study[J]. Teratology, 2002, 65(3):106-115.
[31]
Stingone JA, Luben TJ, Carmichael SL, et al. Maternal exposure to nitrogen dioxide, intake of methyl nutrients, and congenital heart defects in offspring[J]. Am J Epidemiol, 2017, 186(6):719-729.
[32]
Baardman ME, Kerstjens-Frederikse WS, Corpeleijn E, et al. Combined adverse effects of maternal smoking and high body mass index on heart development in offspring:evidence for interaction?[J]. Heart, 2012, 98(6):474-479.
[33]
Strobino B, Abid S, Gewitz M. Maternal lyme disease and congenital heart disease:a case-control study in an endemic area[J]. Am J Obstet Gynecol, 1999, 180(3 Pt 1):711-716.
[34]
Verkleij-Hagoort AC, de Vries JH, Ursem NT, et al. Dietary intake of B-vitamins in mothers born a child with a congenital heart defect[J]. Eur J Nutr, 2006, 45(8):478-486.
[35]
Botto LD, Panichello JD, Browne ML, et al. Congenital heart defects after maternal fever[J]. Am J Obstet Gynecol, 2014, 210(4):359.e1-359.e11.
[36]
Tikkanen J, Heinonen OP. Maternal exposure to chemical and physical factors during pregnancy and cardiovascular malformations in the offspring[J]. Teratology, 1991, 43(6):591-600.
[37]
van Beynum IM, Kapusta L, Bakker MK, et al. Protective effect of periconceptional folic acid supplements on the risk of congenital heart defects:a registry-based case-control study in the northern Netherlands[J]. Eur Heart J, 2010, 31(4):464-471.
[38]
van Driel LM, de Jonge R, Helbing WA, et al. Maternal global methylation status and risk of congenital heart diseases[J]. Obstet Gynecol, 2008, 112(2 Pt 1):277-283.
[39]
Wang C, Xie L, Zhou K, et al. Increased risk for congenital heart defects in children carrying the ABCB1 Gene C3435T polymorphism and maternal periconceptional toxicants exposure[J]. PLoS One, 2013, 8(7):e68807.
[40]
Wang C, Zhan Y, Wang F, et al. Parental occupational exposures to endocrine disruptors and the risk of simple isolated congenital heart defects[J]. Pediatr Cardiol, 2015, 36(5):1024-1037.
[41]
Williams LJ, Correa A, Rasmussen S. Maternal lifestyle factors and risk for ventricular septal defects[J]. Birth Defects Res A Clin Mol Teratol, 2004, 70(2):59-64.
[42]
Yauck JS, Malloy ME, Blair K, et al. Proximity of residence to trichloroethylene-emitting sites and increased risk of offspring congenital heart defects among older women[J]. Birth Defects Res A Clin Mol Teratol, 2004, 70(10):808-814.
[43]
Wijnands KP, Zeilmaker GA, Meijer WM, et al. Periconceptional parental conditions and perimembranous ventricular septal defects in the offspring[J]. Birth Defects Res A Clin Mol Teratol, 2014, 100(12):944-950.
[44]
Liu X, Nie Z, Chen J, et al. Does maternal environmental tobacco smoke interact with social-demographics and environmental factors on congenital heart defects?[J]. Environ Pollut, 2018, 234:214-222.
[45]
Guo L, Zhao D, Zhang R, et al. A matched case-control study on the association between colds, depressive symptoms during pregnancy and congenital heart disease in Northwestern China[J]. Sci Rep, 2019, 9(1):589.
Burd L, Deal E, Rios R, et al. Congenital heart defects and fetal alcohol spectrum disorders[J]. Congenit Heart Dis, 2007, 2(4):250-255.
[66]
Tikkanen J, Heinonen OP. Risk factors for ventricular septal defect in Finland[J]. Public Health, 1991, 105(2):99-112.
[67]
Zhang S, Wang L, Yang T, et al. Parental alcohol consumption and the risk of congenital heart diseases in offspring:an updated systematic review and meta-analysis[J]. Eur J Prev Cardiol, 2020, 27(4):410-421.
[68]
Serrano M, Han M, Brinez P, et al. Fetal alcohol syndrome:cardiac birth defects in mice and prevention with folate[J]. Am J Obstet Gynecol, 2010, 203(1):75.e7-75.e15.
Sun J, Chen X, Chen H, et al. Maternal alcohol consumption before and during pregnancy and the risks of congenital heart defects in offspring:a systematic review and meta-analysis[J]. Congenit Heart Dis, 2015, 10(5):E216-E224.
[71]
Wen Z, Yu D, Zhang W, et al. Association between alcohol consumption during pregnancy and risks of congenital heart defects in offspring:meta-analysis of epidemiological observational studies[J]. Ital J Pediatr, 2016, 42:E216-E224.
