Maternal cigarette smoking and alcohol consumption and congenital diaphragmatic hernia

Abstract

Background: Congenital diaphragmatic hernia (CDH) occurs when abnormal diaphragm development allows herniation of abdominal organs into the thoracic cavity. Its etiopathogenesis is not well understood, but cigarette smoking and alcohol exposure may impact diaphragm development. Using data from a large, population-based case-control study, we examined associations between maternal cigarette smoking and alcohol consumption and CDH in offspring.Methods: We analyzed maternal interview reports of cigarette smoking and alcohol consumption during early pregnancy for 831 children with CDH and 11,416 children without birth defects with estimated dates of delivery during 1997-2011. Generalized linear mixed effects models with a random intercept for study site were used to estimate associations between measures of exposure to smoking (any, type, frequency, duration) and alcohol (any, quantity, frequency, variability, type) for all CDH combined and selected subtypes (Bochdalek and Morgagni).Results: Mothers of 280 (34.0%) case and 3,451 (30.3%) control children reported early pregnancy exposure to cigarette smoking. Adjusted odds ratios Julia Finn and Jonathan Suhl contributed equally to this study.

Birth Defects Associated with Prenatal Alcohol Exposure—A Review

“…In total, 12 studies evaluated herniation and PAE and all of them used casecontrol designs. The majority classified PAE in the periconceptional period (83%) [62][63][64][65][66][67][68][69][70][71]. Details of the findings are as follows:…”

“…There were three studies that evaluated diaphragmatic hernias (Supplementary Table S5). Two queried about alcohol use before and in early pregnancy [62,63], although results from both studies, which also assessed exposure by quantity, were null. In a third study that assessed any report of alcohol use in pregnancy, PAE conferred a 3.5-fold increase in odds of diaphragmatic hernia (OR = 3.6, 95% CI 1.4, 9.8) [72].…”