Prenatal Alcohol Exposure and Congenital Heart Defects: A Meta-Analysis

Abstract

BackgroundThere are still inconsistent conclusions about the association of prenatal alcohol drinking with congenital heart defects (CHDs). We conducted this meta-analysis to investigate the association between prenatal alcohol exposure and the risk of overall CHDs and the CHDs subtypes.MethodsCase-control and cohort studies published before March 2015 were searched through PubMed and Embase. Two authors independently extracted data and scored the study quality according to the Newcastle-0ttawa Scale. The pooled ORs and 95%CI were estimated using the random-effects model and heterogeneity was assessed by the Q test and I2 statistic.ResultsA total of 20 studies were finally included. The results provided no evidence of the association between prenatal alcohol exposure and the risk of overall CHDs (OR = 1.06, 95%CI = 0.93–1.22), ventricular septal defects (VSDs) (OR = 1.04, 95%CI = 0.86–1.25), or atrial septal defects (ASDs) (OR = 1.40, 95%CI = 0.88–2.23). However, prenatal alcohol drinking was marginally significantly associated with conotruncal defects (CTDs) (OR = 1.24, 95%CI = 0.97–1.59) and statistically significantly associated with d-Transposition of the Great Arteries (dTGA) (OR = 1.64, 95%CI = 1.17–2.30). Moreover, both prenatal heavy drinking and binge drinking have a strong association with overall CHDs (heavy drinking: OR = 3.76, 95%CI = 1.00–14.10; binge drinking: OR = 2.49, 95%CI = 1.04–5.97), and prenatal moderate drinking has a modest association with CTDs (OR = 1.35, 95%CI = 1.05–1.75) and dTGA (OR = 1.86, 95%CI = 1.09–3.20).ConclusionsIn conclusion, the results suggested that prenatal alcohol exposure was not associated with overall CHDs or some subtypes, whereas marginally significant association was found for CTDs and statistically significant association was found for dTGA. Further prospective studies with large population and better designs are needed to explore the association of prenatal alcohol exposure with CHDs including the subtypes in specific groups.

Responding to fetal alcohol spectrum disorder in Australia

“…PAE can also result in fetal growth restriction and congenital deficits including heart, renal and gastrointestinal abnormalities . FASD may be the explanation for some children presenting with poor growth during childhood.…”

“…PAE can also result in fetal growth restriction and congenital deficits including heart, renal and gastrointestinal abnormalities. 26,27 FASD may be the explanation for some children presenting with poor growth during childhood. In some countries impaired growth remains a diagnostic criteria for FASD, although this has been removed from the Canadian and Australian Guide to Diagnosis.…”

Congenital Heart Diseases in Children: Incidence, Risk Factors, Mortality

“…Согласно результатам метаанализа, опубликованного в 2015 г., выявлена ассоциация пренатального приема алкоголя с увеличением вероятности конотрункальных дефектов в 1,24 раза и риска транспозиции магистраль-ных сосудов в 1,64 раза [51].…”

Common congenital anomalies: Environmental causes and prevention with folic acid containing multivitamins

“…CHDs are commonly associated with FASD. Those patients display various CHDs, such as ventricular and/or atrial septal defects, conotruncal defects, and unspecified defects (Burd et al, 2007;Grewal et al, 2008;Yang et al, 2015;Zhu et al, 2015). Embryonic ethanol exposure produces heart defects in animal models that recapitulate the defects seen in human patients (Webster et al, 1984;Daft et al, 1986;Fang et al, 1987;Bruyere and Stith, 1993;Sarmah and Marrs, 2013;Sarmah et al, 2016b).…”