Association between maternal smoke exposure and congenital heart defects from a case–control study in China

Abstract

There is a gap in knowledge how maternal exposure to environmental tobacco smoke (ETS) is associated with offspring congenital heart defects (CHDs). In this case–control study, we collected data on 749 fetuses with CHDs and 880 fetuses without any congenital anomalies to examine the association of maternal ETS with fetal CHDs and the potentially moderating effect by maternal hazardous and noxious substances (HNS), periconceptional folate intake and paternal smoking. Maternal exposure to ETS in first trimester was associated with increased risk of CHDs in a dose–response gradient, with the AORs (95% CI) were1.38 (1.00–1.92), 1.60 (1.07–2.41), and 4.94 (2.43–10.05) for ETS < 1 h/day, 1–2 h/day, and ≥ 2 h/day, respectively. With the doubly unexposed group as reference categories, AORs for maternal ETS exposure ≥ 2 h/day in the absence of folate intake, in the presence of HNS exposure or paternal smoking, were 7.21, 11.43, and 8.83, respectively. Significant additive interaction between ETS exposure and maternal folate intake on CHDs was detected. Maternal ETS exposure during first trimester may increase the risk of offspring CHDs in a dose–response shape, and such effect may be modified by maternal folate intake or other potential factors.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

“…Periconceptional cigarette smoking 21–24 1 month before conception through 3 months after conception is associated with an increased odds of ASD (OR, 1.7 [95% CI, 1.5–2.0]), truncus arteriosus (OR, 1.7 [95% CI, 1.0–2.7]), any septal defect (OR, 1.5 [95% CI, 1.3–1.7]), double-outlet right ventricle (OR, 1.3 [95% CI, 1.1–2.2]), perimembranous VSD (OR, 1.3, [95% CI, 1.0–1.4]), atrioventricular septal defect (OR, 1.3 [95% CI, 1.0–1.9]), right-sided obstructive lesion (OR, 1.2 [95% CI, 1.0–1.4]), and pulmonary valve stenosis (OR, 1.2 [95% CI, 1.0–1.4]). There was not a significant association between this exposure and truncus arteriosus (OR, 1.2 [95% CI, 0.7–2.1]) and Ebstein anomaly (OR, 1.1 [95% CI, 0.7–1.8]).…”

The Impact of Prenatal Environmental Tobacco Smoking (ETS) and Exposure on Chinese Children: A Systematic Review

“…Both Song et al [ 42 ] and Wang et al [ 41 ] reported an increased risk of CHD in offspring whose mothers were exposed to SHS during the three months before pregnancy. All three identified articles showed significant associations between maternal exposure to ETS and CHDs in their offspring [ 42 , 45 , 46 ] also found a dose–response gradient between the risk of CHDs and maternal exposure to ETS in first trimester of pregnancy.…”

Maternal smoking around birth and its influence on offspring allergic diseases: A mendelian randomization study

“…This widespread habit could impair the intrauterine environment and adversely affect the developing organs of offspring. 3 , 4 Previous studies have extensively documented the correlation between maternal smoking during pregnancy and low birth weight, 5 , 6 , 7 premature births, 8 congenital heart defects, 9 , 10 chronic obstructive pulmonary disease, 11 anxiety and depression, 12 and other disorders in offspring.…”