A case-control study on the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease in offspring

LI Liu-Xuan; LUO Man-Jun; RUAN Xiao-Rui; LIU Han-Jun; TANG Jia-Peng; YANG Gui-Hong; QIN Jia-Bi

doi:10.7499/j.issn.1008-8830.2404116

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Chinese Journal of Contemporary Pediatrics ›› 2024, Vol. 26 ›› Issue (10) : 1019-1026. DOI: 10.7499/j.issn.1008-8830.2404116

CLINICAL RESEARCH

A case-control study on the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease in offspring

LI Liu-Xuan, LUO Man-Jun, RUAN Xiao-Rui, LIU Han-Jun, TANG Jia-Peng, YANG Gui-Hong, QIN Jia-Bi

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Abstract

Objective To explore the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease (CHD) in offspring. Methods The parents of children with simple CHD aged 0 to 1 year (n=683) were recruited as the case group, while the parents of healthy children aged 0 to 1 year (n=740) served as the control group. A case-control study was conducted, and a questionnaire was used to collect information on perinatal exposures. After controlling for relevant confounding factors using multivariate logistic regression analysis and propensity score matching, the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with CHD were examined, as well as the cumulative effects of smoking and drinking on CHD risk. Results Maternal active smoking (OR=2.91, 95%CI: 1.60-5.30), passive smoking (OR=1.94, 95%CI: 1.56-2.42), and alcohol consumption (OR=2.59, 95%CI: 1.89-3.54), as well as paternal smoking (OR=1.52; 95%CI: 1.22-1.90) and drinking (OR=1.48, 95%CI: 1.19-1.84), were associated with an increased risk of CHD in offspring. There was no interaction between parental smoking and drinking behaviors during the periconceptional period concerning the risk of CHD in offspring (P>0.05). The more parents' smoking and drinking behaviors during the perinatal pregnancy, the higher the risk of CHD in their offspring (OR=1.50, 95%CI: 1.36-1.65). Conclusions Parental smoking and alcohol consumption during the periconceptional period are associated with the occurrence of CHD in offspring, and there is a cumulative effect on CHD risk, suggesting that reducing tobacco and alcohol exposure during the periconceptional period may lower the incidence of CHD.

Key words

Congenital heart disease / Smoking / Alcohol consumption / Interaction / Case-control study / Offspring

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LI Liu-Xuan, LUO Man-Jun, RUAN Xiao-Rui, LIU Han-Jun, TANG Jia-Peng, YANG Gui-Hong, QIN Jia-Bi. A case-control study on the associations of parental smoking and alcohol consumption during the periconceptional period and their interactions with risk of congenital heart disease in offspring[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(10): 1019-1026 https://doi.org/10.7499/j.issn.1008-8830.2404116

References

1 Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association[J]. Circulation, 2012, 125(1): e2-e220. PMID: 22179539. PMCID: PMC4440543. DOI: 10.1161/CIR.0b013e31823ac046.
2 Gilboa SM, Salemi JL, Nembhard WN, et al. Mortality resulting from congenital heart disease among children and adults in the United States, 1999 to 2006[J]. Circulation, 2010, 122(22): 2254-2263. PMID: 21098447. PMCID: PMC4911018. DOI: 10.1161/CIRCULATIONAHA.110.947002.
3 Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies[J]. Int J Epidemiol, 2019, 48(2): 455-463. PMID: 30783674. PMCID: PMC6469300. DOI: 10.1093/ije/dyz009.
4 Zhao L, Chen L, Yang T, et al. Birth prevalence of congenital heart disease in China, 1980-2019: a systematic review and meta-analysis of 617 studies[J]. Eur J Epidemiol, 2020, 35(7): 631-642. PMID: 32519018. PMCID: PMC7387380. DOI: 10.1007/s10654-020-00653-0.
5 Shillingford AJ, Glanzman MM, Ittenbach RF, et al. Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease[J]. Pediatrics, 2008, 121(4): e759-e767. PMID: 18381503. DOI: 10.1542/peds.2007-1066.
6 潘飞霞, 徐玮泽, 李嘉斌, 等. 中国先天性心脏病疾病负担三十年变化分析[J]. 浙江大学学报（医学版）, 2022, 51(3): 267-277. PMID: 36207836. PMCID: PMC10251186. DOI: 10.3724/zdxbyxb-2022-0072.
7 Bolin EH, Gokun Y, Romitti PA, et al. Maternal smoking and congenital heart defects, national birth defects prevention study, 1997-2011[J]. J Pediatr, 2022, 240: 79-86.e1. PMID: 34508749. PMCID: PMC8712361. DOI: 10.1016/j.jpeds.2021.09.005.
8 Taylor K, Wootton RE, Yang Q, et al. The effect of maternal BMI, smoking and alcohol on congenital heart diseases: a Mendelian randomisation study[J]. BMC Med, 2023, 21(1): 35. PMID: 36721200. PMCID: PMC9890815. DOI: 10.1186/s12916-023-02731-y.
9 Taylor K, Elhakeem A, Thorbj?rnsrud Nader JL, et al. Effect of maternal prepregnancy/early-pregnancy body mass index and pregnancy smoking and alcohol on congenital heart diseases: a parental negative control study[J]. J Am Heart Assoc, 2021, 10(11): e020051. PMID: 34039012. PMCID: PMC8483540. DOI: 10.1161/JAHA.120.020051.
10 Nie Z, Qu Y, Han F, et al. Evaluation of interactive effects between paternal alcohol consumption and paternal socioeconomic status and environmental exposures on congenital heart defects[J]. Birth Defects Res, 2020, 112(16): 1273-1286. PMID: 32696579. DOI: 10.1002/bdr2.1759.
11 郑保义. 世界卫生组织关于吸烟行为调查的基本原则[J]. 中国健康教育, 1992, 8(5): 2-6.
12 王雪茵, 张小松, 周敏, 等. 孕期被动吸烟对妊娠并发症及妊娠结局的影响[J]. 中华疾病控制杂志, 2020, 24(4): 419-423. DOI: 10.16462/j.cnki.zhjbkz.2020.04.010.
13 卢士军, 杜松明, 马冠生. “标准饮酒单位”制定的进展[J]. 卫生研究, 2015, 44(1): 163-166. DOI: 10.19813/j.cnki.weishengyanjiu.2015.01.043.
14 Correa A, Levis DM, Tinker SC, et al. Maternal cigarette smoking and congenital heart defects[J]. J Pediatr, 2015, 166(4): 801-804. PMID: 25681204. PMCID: PMC4406351. DOI: 10.1016/j.jpeds.2015.01.013.
15 Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012[J]. JAMA, 2014, 311(2): 183-192. PMID: 24399557. DOI: 10.1001/jama.2013.284692.
16 Kuciene R, Dulskiene V. Parental cigarette smoking and the risk of congenital heart septal defects[J]. Medicina (Kaunas), 2010, 46(9): 635-641. PMID: 21252599.
17 Malik S, Cleves MA, Honein MA, et al. Maternal smoking and congenital heart defects[J]. Pediatrics, 2008, 121(4): e810-e816. PMID: 18381510. DOI: 10.1542/peds.2007-1519.
18 邓鹏飞, 仲瑷玲, 黄河浪, 等. 儿童先天性心脏病环境暴露因素的病例对照研究[J]. 中华疾病控制杂志, 2015, 19(11): 1135-1137, 1141. DOI: 10.16462/j.cnki.zhjbkz.2015.11.014.
19 郭彦孜, 刘俊, 郑玲芳, 等. 2011-2014年西安咸阳地区先天性心脏病危险因素分析[J]. 临床误诊误治, 2016, 29(1): 80-83. DOI: 10.3969/j.issn.1002-3429.2016.01.030.
20 江燕萍, 欧艳秋, 韩凤珍, 等. 孕母全血中硒浓度与子代先天性心脏病发生的关系[J]. 中华疾病控制杂志, 2017, 21(10): 1066-1070. DOI: 10.16462/j.cnki.zhjbkz.2017.10.023.
21 魏磊, 刘金华, 朱伟, 等. 新疆伊犁州儿童先天性心脏病2: 1配对病例对照病因分析[J]. 南京医科大学学报(自然科学版), 2013, 33(1): 78-82.
22 Deng K, Liu Z, Lin Y, et al. Periconceptional paternal smoking and the risk of congenital heart defects: a case-control study[J]. Birth Defects Res A Clin Mol Teratol, 2013, 97(4): 210-216. PMID: 23554276. DOI: 10.1002/bdra.23128.
23 Zhao L, Chen L, Yang T, et al. Parental smoking and the risk of congenital heart defects in offspring: an updated meta-analysis of observational studies[J]. Eur J Prev Cardiol, 2020, 27(12): 1284-1293. PMID: 30905164. DOI: 10.1177/2047487319831367.
24 Gianicolo EA, Cresci M, Ait-Ali L, et al. Smoking and congenital heart disease: the epidemiological and biological link[J]. Curr Pharm Des, 2010, 16(23): 2572-2577. PMID: 20550501. DOI: 10.2174/138161210792062849.
25 IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking[J]. IARC Monogr Eval Carcinog Risks Hum, 2004, 83: 1-1438. PMID: 15285078. PMCID: PMC4781536.
26 Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy[J]. Lancet, 1973, 302(7836): 999-1001. PMID: 4127281. DOI: 10.1016/s0140-6736(73)91092-1.
27 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. PMID: 31578093. DOI: 10.1177/2047487319874530.
28 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. PMID: 26118863. PMCID: PMC7668305. DOI: 10.1002/bdra.23352.
29 Savitz DA, Schwingl PJ, Keels MA. Influence of paternal age, smoking, and alcohol consumption on congenital anomalies[J]. Teratology, 1991, 44(4): 429-440. PMID: 1962288. DOI: 10.1002/tera.1420440409.
30 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. PMID: 18377476. DOI: 10.1111/j.1747-0803.2007.00105.x.
31 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. PMID: 18481814. PMCID: PMC2861577. DOI: 10.1002/bdra.20461.
32 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. PMID: 20451895. DOI: 10.1016/j.ajog.2010.03.017.
33 Day J, Savani S, Krempley BD, et al. Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype[J]. Am J Stem Cells, 2016, 5(1): 11-18. PMID: 27335698. PMCID: PMC4913293.
34 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 Womens Health (Larchmt), 2012, 21(1): 26-34. PMID: 21895513. DOI: 10.1089/jwh.2010.2582.