Is maternal parity an independent risk factor for birth defects?

Duong, Hao T.; Hoyt, Adrienne T.; Carmichael, Suzan L.; Gilboa, Suzanne M.; Canfield, Mark A.; Case, Amy P.; McNeese, Melanie L.; Waller, D. Kim

doi:10.1002/bdra.22889

Cited by 70 publications

(59 citation statements)

References 45 publications

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“…This was similar for miscarriage, with the crude RR for the current study (3.17 [95% CI 1.70-5.90]) being higher, but not significantly (P = 0.07), than in a U.K. sample of women of reproductive age (1.75 [1.42-2.14], comparing first and second pregnancies). We did not find a relationship between pregnancy order and the risk of congenital anomaly, despite it being observed in the general population (33). This may reflect our modest sample size or the aforementioned problems comparing longitudinal and cross-sectional data.…”

Section: Comparison With Other Studiescontrasting

confidence: 66%

Risk and Recurrence of Serious Adverse Outcomes in the First and Second Pregnancies of Women With Preexisting Diabetes

et al. 2015

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OBJECTIVEWomen with preexisting (type 1 or type 2) diabetes experience an increased risk of serious adverse pregnancy outcomes. It is not known, however, how these risks change between the first and second pregnancy and whether there is an increased risk of recurrence. This study describes the absolute risks and recurrence of serious adverse pregnancy outcomes in 220 women with preexisting diabetes. RESEARCH DESIGN AND METHODSA total of 440 pregnancies occurring in 220 women with preexisting diabetes who delivered successive singleton pregnancies in the North of England during 1996-2008 were identified from the Northern Diabetes in Pregnancy Survey (NorDIP). Predictors of serious adverse outcome were estimated by competing-risks regression. RESULTSSixty-seven first pregnancies (30.5%) ended in serious adverse outcome, including 14 (6.4%) with congenital anomalies and 53 (24.1%) additional fetal or infant deaths. Thirty-seven second pregnancies (16.8%) ended in serious adverse outcomedhalf the rate among first pregnancies (P = 0.0004)dincluding 21 (9.5%) with congenital anomalies and 16 (7.3%) additional fetal or infant deaths. Serious adverse outcomes in the second pregnancy occurred twice as frequently in women who experienced a previous adverse outcome than in those who did not (26.9% vs. 12.4%, P = 0.004), but previous adverse outcome was not associated with preparation for the following pregnancy. CONCLUSIONSSerious adverse outcomes are less common in the second pregnancies of women with preexisting diabetes, although the risk is comparable in those whose first pregnancy ends in adverse outcome. Reducing the risk of recurrence may require more support in the immediate period after an adverse pregnancy outcome.Serious adverse pregnancy outcomes, such as miscarriages, stillbirths, and congenital anomalies, are associated with significant psychological distress, and parents who experience such events are often very anxious about their chances of recurrence (1,2). In the general population, the risks of miscarriage, stillbirth, and congenital anomaly in the second pregnancy are approximately two times greater in women who experienced the same event in their first pregnancy (3-5), although the absolute risks remain low in the absence of clear genetic or physiological factors.

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Section: Comparison With Other Studiescontrasting

confidence: 66%

Risk and Recurrence of Serious Adverse Outcomes in the First and Second Pregnancies of Women With Preexisting Diabetes

et al. 2015

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“…We included nonmodifiable risk factors (male sex [58,59], family history of a first-degree relative with CHD [24,25], and nulliparity [having no previous pregnancies] [59,69]) to estimate the proportion attributable to the full set of recognized risk factors. Although not included as a risk factor in the final model, maternal smoking in B1-P3 was included as a potential confounder.…”

Section: Methodsmentioning

confidence: 99%

Proportion of selected congenital heart defects attributable to recognized risk factors

Simeone

Tinker

Gilboa

et al. 2016

Annals of Epidemiology

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Purpose To assess the contribution of multiple risk factors for two congenital heart defects—hypoplastic left heart syndrome (HLHS) and tetralogy of Fallot (TOF). Methods We used data from the National Birth Defects Prevention Study (1997–2011) to estimate average adjusted population attributable fractions for several recognized risk factors, including maternal prepregnancy overweight–obesity, pregestational diabetes, age, and infant sex. Results There were 594 cases of isolated simple HLHS, 971 cases of isolated simple TOF, and 11,829 controls in the analysis. Overall, 57.0% of HLHS cases and 37.0% of TOF cases were estimated to be attributable to risk factors included in our model. Among modifiable HLHS risk factors, maternal pre-pregnancy overweight–obesity accounted for the largest proportion of cases (6.5%). Among modifiable TOF risk factors, maternal prepregnancy overweight–obesity and maternal age of 35 years or older accounted for the largest proportions of cases (8.3% and 4.3%, respectively). Conclusions Approximately half of HLHS cases and one-third of TOF cases were estimated to be attributable to risk factors included in our models. Interventions targeting factors that can be modified may help reduce the risk of HLHS and TOF development. Additional research into the etiology of HLHS and TOF may reveal other modifiable risk factors that might contribute to primary prevention efforts.

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“…Other than the initiation of pregnancy using ART, other potential confounding factors on malformation rates (Duong et al 2012), such as the age of the woman whose eggs were fertilised, singleton versus multifetal gestation and the rate of nulliparity, could not be compared because these data were not available for the three control studies. The high percentage of family balancing cases makes it likely that the study group had a lower rate of nulliparity and a greater median age than the women in the control studies used for comparison.…”

Section: Discussionmentioning

confidence: 99%

MicroSort® sperm sorting causes no increase in major malformation rate

Marazzo

Karabinus

Johnson

et al. 2016

Reprod. Fertil. Dev.

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Abstract. The purpose of the present study was to evaluate the safety of MicroSort (MicroSort Division, GIVF, Fairfax, VA, USA) sperm sorting by monitoring major malformations in infants and fetuses conceived using sorted spermatozoa. Data were collected in a prospective protocol with monitoring that began from conception through birth until 1 year of life. Comprehensive ascertainment identified fetuses and stillbirths with malformations after 16 weeks gestation, pregnancies terminated for malformations and babies with major malformations. Outcomes in MicroSort pregnancies were compared with outcomes in published studies that used active and comprehensive ascertainment of malformations in the general population and in pregnancies established after assisted reproduction. Using comprehensive outcomes from all pregnancies, the rate of major malformations in MicroSort pregnancies conceived after IVF with or without intracytoplasmic sperm injection was 7.8%; this did not differ significantly from the rates reported in the three assisted reproductive technology control studies not associated with MicroSort (8.6%, 9.2% and 8.3%). Similarly, the rate of major malformations in MicroSort pregnancies initiated with intrauterine insemination was 6.0%, not significantly different from that reported in non-assisted reproductive technology pregnancies not associated with MicroSort (6.9%, 4.6% and 5.7%). Prospective record review of pregnancy outcomes and paediatric evaluation to 1 year indicate no association between MicroSort sperm sorting and major malformations.

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Is maternal parity an independent risk factor for birth defects?

Cited by 70 publications

References 45 publications

Risk and Recurrence of Serious Adverse Outcomes in the First and Second Pregnancies of Women With Preexisting Diabetes

Risk and Recurrence of Serious Adverse Outcomes in the First and Second Pregnancies of Women With Preexisting Diabetes

Proportion of selected congenital heart defects attributable to recognized risk factors

MicroSort® sperm sorting causes no increase in major malformation rate

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