Maternal periconceptional exposure to cigarette smoking and alcohol and esophageal atresia ± tracheo‐esophageal fistula

Wong-Gibbons, Donna L.; Romitti, Paul A.; Sun, Lin; Moore, Cynthia A.; Reefhuis, Jennita; Bell, Erin M.; Olshan, Andrew F.

doi:10.1002/bdra.20529

Cited by 31 publications

(24 citation statements)

References 29 publications

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“…Although a small case–control study by Felix et al . found no association between maternal periconceptional alcohol consumption and EA/TEF, Wong‐Gibbons et al . reported a weak association in a large population‐based case–control study.…”

Section: Discussionmentioning

confidence: 94%

Comparison of environmental risk factors for esophageal atresia, anorectal malformations, and the combined phenotype in 263 German families

et al. 2015

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Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) and anorectal malformations (ARM) represent the severe ends of the fore- and hindgut malformation spectra. Previous research suggests that environmental factors are implicated in their etiology. These risk factors might indicate the influence of specific etiological mechanisms on distinct developmental processes (e.g. fore- vs. hindgut malformation). The present study compared environmental factors in patients with isolated EA/TEF, isolated ARM, and the combined phenotype during the periconceptional period and the first trimester of pregnancy in order to investigate the hypothesis that fore- and hindgut malformations involve differing environmental factors. Patients with isolated EA/TEF (n = 98), isolated ARM (n = 123), and the combined phenotype (n = 42) were included. Families were recruited within the context of two German multicenter studies of the genetic and environmental causes of EA/TEF (great consortium) and ARM (CURE-Net). Exposures of interest were ascertained using an epidemiological questionnaire. Chi-square, Fisher's exact, and Mann-Whitney U-tests were used to assess differences between the three phenotypes. Newborns with isolated EA/TEF and the combined phenotype had significantly lower birth weights than newborns with isolated ARM (P = 0.001 and P < 0.0001, respectively). Mothers of isolated EA/TEF consumed more alcohol periconceptional (80%) than mothers of isolated ARM or the combined phenotype (each 67%). Parental smoking (P = 0.003) and artificial reproductive techniques (P = 0.03) were associated with isolated ARM. Unexpectedly, maternal periconceptional multivitamin supplementation was most frequent among patients with the most severe form of disorder, i.e. the combined phenotype (19%). Significant differences in birth weight were apparent between the three phenotype groups. This might be attributable to the limited ability of EA/TEF fetuses to swallow amniotic fluid, thus depriving them of its nutritive properties. Furthermore, the present data suggest that fore- and hindgut malformations involve differing environmental factors. Maternal periconceptional multivitamin supplementation was highest among patients with the combined phenotype. This latter finding is contrary to expectation, and warrants further analysis in large prospective epidemiological studies.

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Section: Discussionmentioning

confidence: 94%

Comparison of environmental risk factors for esophageal atresia, anorectal malformations, and the combined phenotype in 263 German families

et al. 2015

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“…41,42 Obviously, both genetic and environmental factors have a role in the origin of esophageal atresia/stenosis ± tracheo-esophageal fistula; 42,43 among environmental factors, maternal exposure to cigarette smoking and alcohol during early pregnancy is important. 44,45 The mothers with CAs of both cases (29.7 vs. 21.6%) and controls (22.2 vs. 18.5%), smoked more frequently during pregnancy than case and control mothers without CH. Thus, smoking may be a factor that triggers the genetic pre-disposition to esophageal atresia/stenosis.…”

Section: Discussionmentioning

confidence: 97%

Chronic hypertension with related drug treatment of pregnant women and congenital abnormalities in their offspring: a population-based study

et al. 2010

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Chronic hypertension (CH) is a common chronic disease and occurs frequently in pregnant women. The teratogenic/fetotoxic effect of certain antihypertensive drugs has been shown. The objective of this study was to investigate the association between pregnant women with CH and the possible risk of congenital abnormalities (CAs) among their offspring. The prevalence of medically recorded CH in the prenatal maternity logbook was compared between 1030 pregnant women who later had offspring with CA (case group) and 1579 pregnant women with CH who later delivered newborn infants without CA (control group). Control newborn infants were matched to cases in the population-based data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities during 1980-1996. Of 23 different CA groups with informative offspring, esophageal atresia/stenosis was a greater risk in pregnant women with CH (adjusted odds ratios with 95% confidence intervals: 3.1, 1.4-6.8). In conclusion, a higher risk of esophageal atresia/stenosis was found in the offspring of pregnant women with severe CH, which could not be explained by related drug treatments. This finding requires confirmation or lack thereof by future studies.

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“…In addition, the weight of evidence that air pollutants add to this burden of developmental disease is increasing (144, 146), although it is not always consistent (147). Maternal smoking has also been associated with clubfoot (148), tracheoesophageal-fistula (149, 150), renal agenesis (151). One especially interesting area has been the analysis of polymorphisms, smoking and structural malformations (152)…”

Section: Structural Abnormalitymentioning

confidence: 99%

Environmental exposures and development

Mattison

2010

Current Opinion in Pediatrics

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Structured AbstractPurpose of Review-Summarize recent studies exploring the relationship between paternal and maternal environmental exposures to chemicals before, at the time of and after conception to adverse developmental outcomes including; preterm birth, death, structural and functional abnormalities and growth restriction.Recent Findings-Recent studies have demonstrated that human pregnancy and development is vulnerable to environmental exposures of the father and mother to chemical, biological and physical agents. Exposures associated with adverse developmental outcomes include; air and water pollution, chemicals in foods, occupational exposures, agricultural chemicals, metals, persistent and volatile organics. Developmental endpoints which are linked with these exposures include; growth restriction, functional abnormalities, structural abnormalities, preterm delivery and death. Despite this general understanding we still have incomplete knowledge concerning most exposures and the biological interactions responsible for impaired development and preterm delivery.Summary-While single genes and individual chemical exposures are responsible for some instances of adverse pregnancy outcome or developmental disease, gene-environment interactions are responsible for the majority. These gene-environment interactions may occur in the father, mother, placenta or fetus suggesting that critical attention be given to maternal and paternal exposures and gene expression as they relate to the mode of action of the putative developmental toxicant both prior to and during pregnancy.

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Maternal periconceptional exposure to cigarette smoking and alcohol and esophageal atresia ± tracheo‐esophageal fistula

Abstract: These results, based on one of the largest published samples of EA+/-TEF cases, suggest a role for these exposures in the etiology of EA+/-TEF, although further study is needed to replicate the observed associations.

Cited by 31 publications

References 29 publications

Comparison of environmental risk factors for esophageal atresia, anorectal malformations, and the combined phenotype in 263 German families

Comparison of environmental risk factors for esophageal atresia, anorectal malformations, and the combined phenotype in 263 German families

Chronic hypertension with related drug treatment of pregnant women and congenital abnormalities in their offspring: a population-based study

Environmental exposures and development

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