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Lemieux A, Khalilipalandi S, Lauzon-Schnittka J, Tousignant A, Perreault L, Rego K, Dubois M, Watelle L, Roy LO, Dallaire F. Meta-analysis of risk factors for congenital heart disease - part 2: maternal medication, reproductive technologies, and familial and fetal factors. Can J Cardiol 2024:S0828-282X(24)00949-8. [PMID: 39288833 DOI: 10.1016/j.cjca.2024.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 09/09/2024] [Accepted: 09/11/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND The quantitative effects of congenital heart disease (CHD) risk factors are not fully understood. We conducted a meta-analysis of all CHD risk factors. This report explores maternal medication, assisted reproductive technologies (ART), and familial and fetal factors. METHODS Relevant studies were identified using a search strategy encompassing the concepts of CHD and prenatal risk factors with the following inclusion criteria: (1) peer-reviewed articles, (2) quantifying the effects of CHD risk factors, (3) between 1989 and 2022. Pooled odds ratios (OR) and 95% confidence interval (CI) were calculated using a random effect model. RESULTS 131 articles met the inclusion criteria. Associations were found between CHDs and extracardiac anomalies (OR 3.41, 95% CI 1.72-6.77), increased nuchal translucency (OR 6.87, 95% CI 2.42-19.53), family history of CHD (OR 2.90, 95% CI 2.25-3.75), maternal antidepressants (OR 1.23, 95% CI 1.09-1.38) and antihypertensives (OR 2.07, 95% CI 1.80-2.38). A positive association was observed between severe CHDs and lithium, but with a very wide CI encompassing the null effect. A positive association was observed between severe CHDs and ARTs (OR 1.98, 95% CI 1.30-3.02). The data were insufficient for anomalies of the umbilical cord, anticonvulsants and retinoid medication. CONCLUSION There were strong associations between CHDs and increased nuchal translucency, extracardiac anomalies and family history of CHD. Effect sizes were modest for maternal medication and ART. Data was scarce and sometimes inconclusive for some risk factors commonly cited as being associated with CHD, such as lithium, anomalies of the umbilical cord, anticonvulsants, and retinoid medication.
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Affiliation(s)
- Alyssia Lemieux
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Sara Khalilipalandi
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Jonathan Lauzon-Schnittka
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Angélique Tousignant
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Laurence Perreault
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Kevin Rego
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Mélodie Dubois
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Laurence Watelle
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Louis-Olivier Roy
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada
| | - Frédéric Dallaire
- Faculty of medicine and health sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, Canada.
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Khalilipalandi S, Lemieux A, Lauzon-Schnitka J, Perreault L, Dubois M, Tousignant A, Watelle L, Pratte G, Dallaire F. Systematic Review and Meta-analysis of Prenatal Risk Factors for Congenital Heart Disease: Maternal Chronic Diseases and Parental Exposures. Can J Cardiol 2024:S0828-282X(24)00524-5. [PMID: 38996968 DOI: 10.1016/j.cjca.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/14/2024] [Accepted: 07/05/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND There is considerable heterogeneity in studies on prenatal risk factors for congenital heart diseases (CHDs). We performed a meta-analysis of all nongenetic factors of CHDs. This report presents results of factors related to maternal chronic diseases and parental exposures. METHODS A systematic search encompassing concepts of CHD and risk factors was used, using the following inclusion criteria: (1) original peer-reviewed articles, (2) quantifying the effects of risk factors for CHDs, (3) between 1989 and 2022. Pooled odds ratios (ORs) and 95% confidence interval (CI) were calculated using a random-effect model. RESULTS Inclusion criteria were met for 170 studies. There was an association between being overweight or obese and CHDs (OR, 1.26; 95% CI, 1.15-1.37), with a dose-effect relationship. Pregestational diabetes (PGDM) was associated with CHDs (OR, 3.51; 95% CI, 2.86-4.3), without difference between type 1 and type 2 PGDM. The effect size of gestational diabetes was less than that of PGDM (OR, 1.38; 95% CI, 1.18-1.61). There was an association between CHDs and pre-eclampsia (OR, 2.01; 95% CI, 1.32-3.05), paternal smoking (OR, 1.32; 95% CI, 1.03-1.70), and alcohol use (OR, 1.50; 95% CI, 1.08-2.08). A smaller association was found with maternal smoking and advanced maternal age. CONCLUSIONS There exists robust evidence for increased risk of CHD in the presence of obesity, maternal diabetes, maternal smoking, and increased maternal age. The effect sizes were relatively modest, except for PGDM. The robustness of the evidence decreased when CHDs were divided into subgroups or when the analyses were restricted to severe CHDs.
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Affiliation(s)
- Sara Khalilipalandi
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Alyssia Lemieux
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Jonathan Lauzon-Schnitka
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Laurence Perreault
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Mélodie Dubois
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Angélique Tousignant
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Laurence Watelle
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Gabriel Pratte
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada
| | - Frédéric Dallaire
- Faculty of Medicine and Health Sciences, Université de Sherbrooke and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebéc, Canada.
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Su Y, Yu Y, Quan J, Zhang J, Xu Y. Alcohol exposure during pregnancy induces cardiac mitochondrial damage in offspring mice. Birth Defects Res 2024; 116:e2369. [PMID: 38877673 DOI: 10.1002/bdr2.2369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) has been linked to congenital heart disease and fetal alcohol syndrome. The heart primarily relies on mitochondria to generate energy, so impaired mitochondrial function due to alcohol exposure can significantly affect cardiac development and function. Our study aimed to investigate the impact of PAE on myocardial and mitochondrial functions in offspring mice. METHODS We administered 30% alcohol (3 g/kg) to pregnant C57BL/6 mice during the second trimester. We assessed cardiac function by transthoracic echocardiography, observed myocardial structure and fibrosis through staining tests and electron transmission microscopy, and detected cardiomyocyte apoptosis with dUTP nick end labeling assay and real-time quantitative PCR. Additionally, we measured the reactive oxygen species content, ATP level, and mitochondrial DNA copy number in myocardial mitochondria. Mitochondrial damage was evaluated by assessing the level of mitochondrial membrane potential and the opening degree of mitochondrial permeability transition pores. RESULTS Our findings revealed that PAE caused cardiac systolic dysfunction, ventricular enlargement, thinned ventricular wall, cardiac fibrosis in the myocardium, scattered loss of cardiomyocytes, and disordered arrangement of myocardial myotomes in the offspring. Furthermore, we observed a significant increase in mitochondrial reactive oxygen species content, a decrease in mitochondrial membrane potential, ATP level, and mitochondrial DNA copy number, and sustained opening of mitochondrial permeability transition pores in the heart tissues of the offspring. CONCLUSIONS These results indicated that PAE had adverse effects on the cardiac structure and function of the newborn mice and could trigger oxidative stress in their myocardia and contribute to mitochondrial dysfunction.
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Affiliation(s)
- Yujuan Su
- Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yujuan Yu
- Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Junjun Quan
- Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Junjie Zhang
- Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Xu
- Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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Wang Y, Wang L, Zang H, Wang J, Wu H, Zhao W. Comparison of Different Ultrasonic Screening Methods and Analysis of High Risk Factors for Fetal Cardiac Malformation in Second Trimester of Pregnancy. Pediatr Cardiol 2024:10.1007/s00246-024-03525-6. [PMID: 38809278 DOI: 10.1007/s00246-024-03525-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/13/2024] [Indexed: 05/30/2024]
Abstract
Current study aims to compare the application of two-dimensional (2D) color doppler ultrasound (CDU) and four-dimensional (4D) ultrasound spatiotemporal image correlation (STIC) in fetal congenital heart disease in the second trimester of pregnancy and to analyze the high risk factors of the disease. From August 2019 to July 2021, 135 second-trimester patients with highly suspected congenital heart malformations were selected who underwent prenatal screening at South Taihu Hospital Affiliated to Huzhou University. 2D-CDU, 4D STIC, and postnatal examination were completed in all patients. 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC were used to detect fetal cardiac malformations and classify cardiac malformations. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC were compared. The results of 2D-CDU, 4D STIC and 2D-CDU combined with 4D STIC screening were analyzed for consistency using the results of postpartum diagnosis as the gold standard. Moreover, effects of maternal gestational factors on fetal cardiac malformations by univariate and multivariate analysis. 2D-CDU combined with 4D STIC showed significantly higher section display number than 2D-CDU or 4D STIC in the view of ductal arch, aortic arch, and aortic short-axis. A total of 45 cases of fetal congenital heart malformation were detected in 135 patients in the second trimester, 40, 38 or 42 cases were detected by 2D-CDU, 4D STIC or 2D-CDU combined with 4D STIC, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of 2D-CDU combined with 4D ultrasound in congenital heart malformation screening were higher than those of 2D-CDU or 4D STIC. Kappa agreement analysis showed that the diagnostic results of 4D STIC and 2D-CDU combined with 4D ultrasound in fetuses with suspected congenital heart malformation were in excellent agreement (κ > 0.75), while 2D-CDU was in good agreement with postpartum diagnosis (κ < 0.75). Univariate and multivariate regression analysis revealed that maternal age ≥ 35, drinking during pregnancy, and history of adverse pregnancy and childbirth were all independent risk factors for fetal cardiac malformations, while folic acid supplementation was an independent protective factor for fetal cardiac malformations. 2D-CDU combined with 4D echocardiography may be superior to single 2D-CDU or 4D STIC in the screening of fetal congenital heart malformation in the second trimester. In order to reduce the incidence of fetal heart anomalies, we should strengthen the screening of pregnancy anomalies in high-risk pregnant women and control the risk factors.
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Affiliation(s)
- Yanming Wang
- Department of Ultrasonography, South Taihu Hospital Affiliated to Huzhou College, Huzhou, 313000, Zhejiang Province, People's Republic of China
| | - Longfei Wang
- Department of Anesthesiology, South Taihu Hospital Affiliated to Huzhou College , Huzhou, 313000, Zhejiang Province, People's Republic of China
| | - Haifeng Zang
- Department of Ultrasonography, South Taihu Hospital Affiliated to Huzhou College, Huzhou, 313000, Zhejiang Province, People's Republic of China
| | - Jie Wang
- The People's Hospital of Huaiyang District, Zhoukou, 466700, Henan Province, People's Republic of China
| | - Hao Wu
- Ultrasound Department, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang Province, People's Republic of China.
| | - Wei Zhao
- Ultrasound Department, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang Province, People's Republic of China.
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Fisher SC, Romitti PA, Tracy M, Howley MM, Jabs EW, Browne ML. Associations between maternal periconceptional alcohol consumption and risk of omphalocele among offspring, National Birth Defects Prevention Study, 1997-2011. Prev Med 2024; 180:107891. [PMID: 38342385 DOI: 10.1016/j.ypmed.2024.107891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE Previous studies of alcohol consumption during pregnancy and omphalocele have produced mixed results. We updated an earlier analysis of National Birth Defects Prevention Study (NBDPS) data, adding six years of participants, to examine associations between maternal alcohol consumption and omphalocele. METHODS NBDPS was a multi-site, population-based case-control study in the United States. Cases were identified from birth defect surveillance programs in 10 states; controls were liveborn infants without a birth defect randomly selected from the same catchment areas. Mothers self-reported alcohol consumption during the periconceptional period (one month before through the third gestational month) via telephone interview. Our study included mothers of 410 omphalocele cases and 11,219 controls with estimated dates of delivery (EDDs) during 1997-2011. We used logistic regression to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for periconceptional alcohol consumption and omphalocele. We performed a probabilistic bias analysis to evaluate the impact of alcohol exposure misclassification on our results. RESULTS Overall, 44% of case and 38% of control mothers reported periconceptional alcohol consumption; 22% and 17%, respectively, reported binge drinking. Any maternal periconceptional alcohol consumption was associated with modestly increased odds of omphalocele (AOR 1.35, 95% CI 1.09, 1.68), as was binge drinking (AOR 1.47, 95% CI 1.08, 2.01). Our bias analysis yielded estimates further from the null. CONCLUSIONS We observed modest associations between maternal periconceptional alcohol consumption and omphalocele. Based on our bias analysis, studies of alcohol and birth defects not accounting for exposure misclassification may underestimate associations.
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Affiliation(s)
- Sarah C Fisher
- Birth Defects Registry, New York State Department of Health, Albany, NY, United States.
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, United States
| | - Meredith M Howley
- Birth Defects Registry, New York State Department of Health, Albany, NY, United States
| | - Ethylin Wang Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Clinical Genomics, Mayo Clinic, Rochester, MN, United States
| | - Marilyn L Browne
- Birth Defects Registry, New York State Department of Health, Albany, NY, United States; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, United States
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Gualdoni GS, Barril C, Jacobo PV, Pacheco Rodríguez LN, Cebral E. Involvement of metalloproteinase and nitric oxide synthase/nitric oxide mechanisms in early decidual angiogenesis-vascularization of normal and experimental pathological mouse placenta related to maternal alcohol exposure. Front Cell Dev Biol 2023; 11:1207671. [PMID: 37670932 PMCID: PMC10476144 DOI: 10.3389/fcell.2023.1207671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/28/2023] [Indexed: 09/07/2023] Open
Abstract
Successful pregnancy for optimal fetal growth requires adequate early angiogenesis and remodeling of decidual spiral arterioles during placentation. Prior to the initiation of invasion and endothelial replacement by trophoblasts, interactions between decidual stromal cells and maternal leukocytes, such as uterine natural killer cells and macrophages, play crucial roles in the processes of early maternal vascularization, such as proliferation, apoptosis, migration, differentiation, and matrix and vessel remodeling. These placental angiogenic events are highly dependent on the coordination of several mechanisms at the early maternal-fetal interface, and one of them is the expression and activity of matrix metalloproteinases (MMPs) and endothelial nitric oxide synthases (NOSs). Inadequate balances of MMPs and nitric oxide (NO) are involved in several placentopathies and pregnancy complications. Since alcohol consumption during gestation can affect fetal growth associated with abnormal placental development, recently, we showed, in a mouse model, that perigestational alcohol consumption up to organogenesis induces fetal malformations related to deficient growth and vascular morphogenesis of the placenta at term. In this review, we summarize the current knowledge of the early processes of maternal vascularization that lead to the formation of the definitive placenta and the roles of angiogenic MMP and NOS/NO mechanisms during normal and altered early gestation in mice. Then, we propose hypothetical defective decidual cellular and MMP and NOS/NO mechanisms involved in abnormal decidual vascularization induced by perigestational alcohol consumption in an experimental mouse model. This review highlights the important roles of decidual cells and their MMP and NOS balances in the physiological and pathophysiological early maternal angiogenesis-vascularization during placentation in mice.
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Affiliation(s)
| | | | | | | | - Elisa Cebral
- Laboratorio de Reproducción y Fisiología Materno-Embrionaria, Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Departamento de Biodiversidad y Biología Experimental (DBBE), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
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Fisher SC, Howley MM, Tran EL, Ailes EC, Papadopoulos EA, Nembhard WN, Browne ML. Maternal cyclobenzaprine exposure and risk of birth defects in the National Birth Defects Prevention Study (1997-2011) and Birth Defects Study to Evaluate Pregnancy exposureS (2014-2018). Pharmacoepidemiol Drug Saf 2023; 32:855-862. [PMID: 36942828 PMCID: PMC10926911 DOI: 10.1002/pds.5619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Cyclobenzaprine is a muscle relaxant indicated for acute pain. Little is known about cyclobenzaprine's safety during pregnancy. We explored the association between maternal cyclobenzaprine exposure and risk of birth defects among offspring. METHODS We combined data from two large, multi-site, population-based case-control studies in the United States. Cases were identified from birth defects registries across 10 states; controls were liveborn infants without birth defects randomly selected from the same catchment areas. Participants reported cyclobenzaprine use during the month before conception through the third month of pregnancy ("periconception") via computer-assisted telephone interview. We used logistic regression to assess associations between periconceptional cyclobenzaprine exposure and selected structural birth defects. We calculated crude odds ratios (OR) with corresponding 95% confidence intervals (CI). RESULTS Our study included 33 615 cases and 13 110 controls. Overall, 51 case (0.15%) and 9 control (0.07%) participants reported periconceptional cyclobenzaprine use. We observed increased risk for all seven defects with ≥3 exposed cases: cleft palate (OR = 4.79, 95% CI 1.71-13.44), cleft lip (OR = 2.50, 95% CI 0.89-7.02), anorectal atresia/stenosis (OR = 6.91, 95% CI 1.67, 28.65), d-transposition of the great arteries (OR = 6.97, 95% CI 2.17-22.36), coarctation of the aorta (OR = 5.58, 95% CI 1.88-16.58), pulmonary valve stenosis (OR = 4.55, 95% CI 1.10-18.87), and secundum atrial septal defect (OR = 3.08, 95% CI 0.83-11.45). CONCLUSIONS Even in our large sample, cyclobenzaprine use was rare. Our estimates are unadjusted and imprecise so should be interpreted cautiously. These hypothesis-generating results warrant confirmation and further research to explore possible mechanisms.
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Affiliation(s)
- Sarah C. Fisher
- Birth Defects Registry, New York State Department of Health, Albany, New York, USA
| | - Meredith M. Howley
- Birth Defects Registry, New York State Department of Health, Albany, New York, USA
| | - Emmy L. Tran
- Eagle Global Scientific LLC, Atlanta, Georgia, USA
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth C. Ailes
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Wendy N. Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Marilyn L. Browne
- Birth Defects Registry, New York State Department of Health, Albany, New York, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA
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Fisher SC, Howley MM, Romitti PA, Desrosiers TA, Jabs EW, Browne ML. Maternal periconceptional alcohol consumption and gastroschisis in the National Birth Defects Prevention Study, 1997-2011. Paediatr Perinat Epidemiol 2022; 36:782-791. [PMID: 35437856 PMCID: PMC9990374 DOI: 10.1111/ppe.12882] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Gastroschisis is particularly prevalent among offspring of young women and has increased over recent decades. Although previous studies suggest that maternal alcohol consumption is associated with increased gastroschisis risk, none have explored whether maternal age modifies that association. OBJECTIVE The objective of the study was to evaluate associations between self-reported maternal periconceptional alcohol consumption (1 month prior through the third month after conception) and risk of gastroschisis among offspring, by maternal age. METHODS We used data from the National Birth Defects Prevention Study (NBDPS), a multi-site population-based case-control study. The analysis included 1450 gastroschisis cases and 11,829 unaffected liveborn controls delivered during 1997-2011 in ten US states. We estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the individual and joint effects of alcohol consumption and young maternal age at delivery (<25 years vs ≥25 years) on gastroschisis risk. We estimated the relative excess risk due to interaction (RERI) to quantify additive interaction. RESULTS Periconceptional alcohol consumption was common regardless of maternal age (women <25 years: cases 38.8%, controls 29.3%; women ≥25: cases 43.5%, controls 39.5%). Compared with women ≥25 years who did not consume alcohol, we observed increased risk of gastroschisis among women <25 years, with higher estimates among those who consumed alcohol (women <25 years who did not consume alcohol. aOR 5.90, 95% CI 4.89, 7.11; women <25 years who did consume alcohol: aOR 8.21, 95% CI 6.69, 10.07). Alcohol consumption among women ≥25 years was not associated with gastroschisis (aOR 1.12, 95% CI 0.88, 1.42). This suggests super-additive interaction between alcohol consumption and maternal age (RERI -2.19, 95% CI 1.02, 3.36). CONCLUSIONS Periconceptional alcohol consumption may disproportionately increase risk of gastroschisis among young mothers. Our findings support public health recommendations to abstain from alcohol consumption during pregnancy.
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Affiliation(s)
- Sarah C Fisher
- Birth Defects Registry, New York State Department of Health, Albany, New York, USA
| | - Meredith M Howley
- Birth Defects Registry, New York State Department of Health, Albany, New York, USA
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ethylin Wang Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Marilyn L Browne
- Birth Defects Registry, New York State Department of Health, Albany, New York, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA
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Abraham S, Lindo C, Peoples J, Cox A, Lytle E, Nguyen V, Mehta M, Alvarez JD, Yooseph S, Pacher P, Ebert SN. Maternal binge alcohol consumption leads to distinctive acute perturbations in embryonic cardiac gene expression profiles. Alcohol Clin Exp Res 2022; 46:1433-1448. [PMID: 35692084 DOI: 10.1111/acer.14880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Excessive alcohol consumption during pregnancy is associated with high risk of congenital heart defects, but it is unclear how alcohol specifically affects heart development during the acute aftermath of a maternal binge drinking episode. We hypothesize that administration of a single maternal binge dose of alcohol to pregnant mice at embryonic day 9.5 (E9.5) causes perturbations in the expression patterns of specific genes in the developing heart in the acute period (1-3 days) following the binge episode. To test this hypothesis and identify strong candidate ethanol-sensitive target genes of interest, we adapted a mouse binge alcohol model that is associated with a high incidence of congenital heart defects as described below. METHODS/RESULTS Pregnant mice were administered a single dose of alcohol (2.5 g/kg in saline) or control (saline alone) via oral gavage. To evaluate the impact of maternal binge alcohol on cardiac gene expression profiles, we isolated embryonic hearts from both groups (n = 5/group) at 24, 48, and 72 h post-gavage for transcriptomic analyses. RNA was extracted and evaluated using quantitative RNA-sequencing (RNA-Seq) methods. To identify a cohort of binge-altered cardiac genes, we set the threshold for change at >2.0-fold difference with adjusted p < 0.05 versus control. RNA-Seq analysis of cardiac gene expression revealed that of the 17 genes that were altered within the first 48 h post-binge, with the largest category consisting of transcription factors (Alx1, Alx4, HoxB7, HoxD8, and Runx2), followed by signaling molecules (Adamts18, Dkk2, Rtl1, and Wnt7a). Furthermore, multiple comparative and pathway analyses suggested that several of the candidate genes identified through differential RNA-Seq analysis may interact through certain common pathways. To investigate this further, we performed gene-specific qPCR analyses for three representative candidate targets: Runx2, Wnt7a, and Mlxipl. Notably, only Wnt7a showed significantly (p < 0.05) decreased expression in response to maternal binge alcohol in the qPCR assays. CONCLUSIONS These findings identify Wnt7a and a short list of potential other candidate genes and pathways for further study, which could provide mechanistic insights into how maternal binge alcohol consumption produces congenital cardiac malformations.
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Affiliation(s)
- Shani Abraham
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Chad Lindo
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Jessica Peoples
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Amanda Cox
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Erika Lytle
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Vu Nguyen
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Meeti Mehta
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Jose D Alvarez
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Shibu Yooseph
- Department of Computer Science, Genomics and Bioinformatics Cluster, College of Engineering and Computer Science, University of Central Florida, Orlando, Florida, USA
| | - Pal Pacher
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute of Alcohol and Alcohol Abuse (NIAAA), The National Institutes of Health (NIH), Rockville, Maryland, USA
| | - Steven N Ebert
- Division of Metabolic and Cardiovascular Science, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
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10
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Gualdoni GS, Jacobo PV, Barril C, Ventureira MR, Cebral E. Early Abnormal Placentation and Evidence of Vascular Endothelial Growth Factor System Dysregulation at the Feto-Maternal Interface After Periconceptional Alcohol Consumption. Front Physiol 2022; 12:815760. [PMID: 35185604 PMCID: PMC8847216 DOI: 10.3389/fphys.2021.815760] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/28/2021] [Indexed: 01/16/2023] Open
Abstract
Adequate placentation, placental tissue remodeling and vascularization is essential for the success of gestation and optimal fetal growth. Recently, it was suggested that abnormal placenta induced by maternal alcohol consumption may participate in fetal growth restriction and relevant clinical manifestations of the Fetal Alcohol Spectrum Disorders (FASD). Particularly, periconceptional alcohol consumption up to early gestation can alter placentation and angiogenesis that persists in pregnancy beyond the exposure period. Experimental evidence suggests that abnormal placenta following maternal alcohol intake is associated with insufficient vascularization and defective trophoblast development, growth and function in early gestation. Accumulated data indicate that impaired vascular endothelial growth factor (VEGF) system, including their downstream effectors, the nitric oxide (NO) and metalloproteinases (MMPs), is a pivotal spatio-temporal altered mechanism underlying the early placental vascular alterations induced by maternal alcohol consumption. In this review we propose that the periconceptional alcohol intake up to early organogenesis (first trimester) alters the VEGF-NO-MMPs system in trophoblastic-decidual tissues, generating imbalances in the trophoblastic proliferation/apoptosis, insufficient trophoblastic development, differentiation and migration, deficient labyrinthine vascularization, and uncompleted remodelation and transformation of decidual spiral arterioles. Consequently, abnormal placenta with insufficiency blood perfusion, vasoconstriction and reduced labyrinthine blood exchange can be generated. Herein, we review emerging knowledge of abnormal placenta linked to pregnancy complications and FASD produced by gestational alcohol ingestion and provide evidence of the early abnormal placental angiogenesis-vascularization and growth associated to decidual-trophoblastic dysregulation of VEGF system after periconceptional alcohol consumption up to mid-gestation, in a mouse model.
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11
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Harvey DC, De Zoysa P, Toubat O, Choi J, Kishore J, Tsukamoto H, Kumar SR. Concomitant genetic defects potentiate the adverse impact of prenatal alcohol exposure on cardiac outflow tract maturation. Birth Defects Res 2022; 114:105-115. [PMID: 34859965 PMCID: PMC10033225 DOI: 10.1002/bdr2.1968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) is associated with an increased incidence of congenital heart defects (CHD), in particular outflow tract (OFT) defects. However, the variability in the incidence of CHD following PAE has not been fully explored. We hypothesize that a concomitant, relevant genetic defect would potentiate the adverse effect of PAE and partially explain the variability of PAE-induced CHD incidence. METHODS The OFT is formed by the second heart field (SHF). Our PAE model consisted of two intraperitoneal injections (3 g/kg, separated by 6 hr) of 30% ethanol on E6.5 during SHF specification. The impact of genetic defects was studied by SHF-specific loss of Delta-like ligand 4 (Dll4), fibroblast growth factor 8 (Fgf8) and Islet1. RESULTS Acute PAE alone significantly increased CHD incidence (4% vs. 26%, p = .015) with a particular increase in OFT alignment defects, viz., double outlet right ventricle (0 vs. 9%, p = .02). In embryos with a SHF genetic defect, acute PAE significantly increased CHD incidence (14 vs. 63%, p < .001), including double outlet right ventricle (6 vs. 50%, p < .001) compared to controls. PAE (p = .01) and heterozygous loss of Dll4 (p = .04) were found to independently contribute to CHD incidence, while neither Islet1 nor Fgf8 defects were found to be significant. CONCLUSIONS Our model recapitulates the increased incidence of OFT alignment defects seen in the clinic due to PAE. The presence of a concomitant SHF genetic mutation increases the incidence of PAE-related OFT defects. An apparent synergistic interaction between PAE and the loss of DLL4-mediated Notch signaling in OFT alignment requires further analysis.
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Affiliation(s)
- Drayton C Harvey
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Prashan De Zoysa
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Omar Toubat
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Jongkyu Choi
- Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Jahnavi Kishore
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Hidekazu Tsukamoto
- Department of Pathology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
- Southern California Research Center for ALPD and Cirrhosis, Los Angeles, California, USA
- Greater Los Angeles VA Healthcare System, Los Angeles, California, USA
| | - S Ram Kumar
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
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12
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Harvey DC, Baer RJ, Bandoli G, Chambers CD, Jelliffe-Pawlowski LL, Kumar SR. Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects. J Am Heart Assoc 2022; 11:e022175. [PMID: 35014860 PMCID: PMC9238516 DOI: 10.1161/jaha.121.022175] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background The pathogenesis of congenital heart disease (CHD) remains largely unknown, with only a small percentage explained solely by genetic causes. Modifiable environmental risk factors, such as alcohol, are suggested to play an important role in CHD pathogenesis. We sought to evaluate the association between prenatal alcohol exposure and CHD to gain insight into which components of cardiac development may be most vulnerable to the teratogenic effects of alcohol. Methods and Results This was a retrospective analysis of hospital discharge records from the California Office of Statewide Health Planning and Development and linked birth certificate records restricted to singleton, live‐born infants from 2005 to 2017. Of the 5 820 961 births included, 16 953 had an alcohol‐related International Classification of Diseases, Ninth and Tenth Revisions (ICD‐9; ICD‐10) code during pregnancy. Log linear regression was used to calculate risk ratios (RR) for CHD among individuals with an alcohol‐related ICD‐9 and ICD10 code during pregnancy versus those without. Three models were created: (1) unadjusted, (2) adjusted for maternal demographic factors, and (3) adjusted for maternal demographic factors and comorbidities. Maternal alcohol‐related code was associated with an increased risk for CHD in all models (RR, 1.33 to 1.84); conotruncal (RR, 1.62 to 2.11) and endocardial cushion (RR, 2.71 to 3.59) defects were individually associated with elevated risk in all models. Conclusions Alcohol‐related diagnostic codes in pregnancy were associated with an increased risk of an offspring with a CHD, with a particular risk for endocardial cushion and conotruncal defects. The mechanistic basis for this phenotypic enrichment requires further investigation.
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Affiliation(s)
- Drayton C Harvey
- Department of Surgery Keck School of Medicine of University of Southern California Los Angeles CA
| | - Rebecca J Baer
- Department of Pediatrics and Herbert Wertheim School of Public Health and Longevity Science University of California San Diego La Jolla CA.,The California Preterm Birth Initiative University of California San Francisco San Francisco CA.,Department of Obstetrics, Gynecology and Reproductive Sciences University of California San Francisco San Francisco CA
| | - Gretchen Bandoli
- Department of Pediatrics and Herbert Wertheim School of Public Health and Longevity Science University of California San Diego La Jolla CA
| | - Christina D Chambers
- Department of Pediatrics and Herbert Wertheim School of Public Health and Longevity Science University of California San Diego La Jolla CA
| | - Laura L Jelliffe-Pawlowski
- The California Preterm Birth Initiative University of California San Francisco San Francisco CA.,Department of Epidemiology and Biostatistics University of California San Francisco San Francisco CA
| | - S Ram Kumar
- Department of Surgery Keck School of Medicine of University of Southern California Los Angeles CA.,Department of Pediatrics Keck School of Medicine of University of Southern California Los Angeles CA.,Heart Institute, Children's Hospital Los Angeles Los Angeles CA
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13
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Liu Z, Wang M, Tang Q, He F, Li N, Deng Y, Yu P, Zhu J, Li X. Unintended pregnancy-related factors and the occurrence of offspring congenital heart disease: a multi-site case-control study in China. EUR J CONTRACEP REPR 2021; 26:221-226. [PMID: 33624567 DOI: 10.1080/13625187.2020.1862081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to explore the association between unintended pregnancy and related factors among congenital heart defects (CHDs) in infants. METHODS A total of 1197 cases with isolated CHDs and 1125 controls without any abnormalities were analysed in this multicentre study at seven hospitals in China. According to the pregnancy intention, cases were divided into two groups: planned and unintended pregnancies. The adjusted odds ratio (AOR) was calculated by logistic regression analysis to assess the association between unintended pregnancy and CHD occurrence. The time to prepare for pregnancy and the influencing factors were also compared in this article. RESULTS The risk for CHD occurrence was significantly associated with unintended pregnancy (AOR: 1.42; 95%CI: 1.16-1.73), which may increase the risks for each subtype of CHD occurrence. Risks such as parental smoking, housing renovation, accidental alcohol consumption, lack of health check-ups, and no folic acid supplementation before pregnancy were distributed differently among the planned and unintended pregnancy groups and were associated with CHD occurrence. However, there was no significant association between the duration of planned pregnancy and the risk of CHDs. CONCLUSIONS Unintended pregnancy increased the risk of CHDs in infants. This risk may be related to some known and unknown factors. SYNOPSIS Some unintended pregnancy related factors may increase the risk for foetal CHDs. The duration of planning pregnancy may not be associated with the risk of CHDs.
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Affiliation(s)
- Zhen Liu
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Meixian Wang
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Qin Tang
- Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Peng'an County, Nanchong, China
| | - Fang He
- Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Qingbaijiang, Chengdu, China
| | - Nana Li
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Ying Deng
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Ping Yu
- Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Jun Zhu
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Ministry of Education, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, China
| | - Xiaohong Li
- National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
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14
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Kurita H, Motoki N, Inaba Y, Misawa Y, Ohira S, Kanai M, Tsukahara T, Nomiyama T. Maternal alcohol consumption and risk of offspring with congenital malformation: the Japan Environment and Children's Study. Pediatr Res 2021; 90:479-486. [PMID: 33230193 PMCID: PMC8460444 DOI: 10.1038/s41390-020-01274-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/20/2020] [Accepted: 09/25/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association between fetal exposure to alcohol and congenital structural disorders remains inconclusive. The present study searched for relationships between maternal alcohol consumption during pregnancy and the risk of congenital malformations. METHODS We evaluated the fixed dataset of a large national birth cohort study including 73,595 mothers with a singleton live birth. Information regarding the alcohol consumption of mothers was obtained from self-reported questionnaires. Physicians assessed for 6 major congenital malformations (congenital heart defects [CHDs], male genital abnormalities, limb defects, cleft lip and/or cleft palate [orofacial clefts (OFC)], severe brain abnormalities, and gastrointestinal obstructions) up to 1 month after birth. Multiple logistic regression analysis was performed to identify associations between maternal alcohol consumption during pregnancy and each malformation. RESULTS The prevalence of maternal drinking in early pregnancy and until the second/third trimester was 46.6% and 2.8%, respectively. The onset of CHD was inversely associated with mothers who quit drinking during early pregnancy (OR 0.85, 95% CI 0.74-0.98). There was no remarkable impact of maternal drinking habit status on the other congenital malformations after adjustment for covariates. CONCLUSIONS Maternal alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital malformations of interest. IMPACT This large-scale Japanese cohort study revealed that no teratogenic associations were found between maternal retrospective reports of periconceptional alcohol consumption and congenital malformations after adjustment for covariates. This is the first nationwide birth cohort study in Japan to assess the effect of maternal alcohol consumption during pregnancy on major congenital malformations. Our finding indicated that maternal low-to-moderate alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital heart defects, male genital abnormalities, limb defects, orofacial clefts, severe brain abnormalities, or gastrointestinal obstructions.
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Affiliation(s)
- Hiroshi Kurita
- grid.263518.b0000 0001 1507 4692Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano Japan ,grid.263518.b0000 0001 1507 4692Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Nagano Japan
| | - Noriko Motoki
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
| | - Yuji Inaba
- grid.263518.b0000 0001 1507 4692Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano Japan ,grid.416376.10000 0004 0569 6596Department of Neurology, Nagano Children’s Hospital, Azumino, Nagano Japan
| | - Yuka Misawa
- grid.263518.b0000 0001 1507 4692Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano Japan ,grid.416376.10000 0004 0569 6596Department of Rehabilitation, Nagano Children’s Hospital, Azumino, Nagano Japan
| | - Satoshi Ohira
- grid.263518.b0000 0001 1507 4692Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano Japan ,grid.263518.b0000 0001 1507 4692Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Matsumoto, Nagano Japan
| | - Makoto Kanai
- grid.263518.b0000 0001 1507 4692Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano Japan
| | - Teruomi Tsukahara
- grid.263518.b0000 0001 1507 4692Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano Japan ,grid.263518.b0000 0001 1507 4692Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano Japan
| | - Tetsuo Nomiyama
- grid.263518.b0000 0001 1507 4692Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano Japan ,grid.263518.b0000 0001 1507 4692Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano Japan
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15
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Zhao J, Cai F, Liu P, Wei J, Chen Q. Gene Environment Interactions Between the COL9A1 Gene and Maternal Drinking of Alcohol Contribute to the Risk of Congenital Talipes Equinovarus. Genet Test Mol Biomarkers 2020; 25:48-54. [PMID: 33372835 DOI: 10.1089/gtmb.2020.0196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have indicated that both genetic and environmental factors contribute to the risk of congenital talipes equinovarus (CTEV). The COL9A1 gene encodes one of the three alpha chains of type IX collagen, which is a key collagen component of hyaline cartilage. Our study aimed to evaluate the effect of COL9A1 gene polymorphisms on susceptibility to CTEV in the Han Chinese population. Methods: A total of 2205 unrelated subjects comprising 692 CTEV patients and 1513 healthy controls were recruited. Demographic and characteristic information was collected, including maternal smoking and maternal drinking. Genetic association analyses and gene-environment interaction analyses were conducted based on the genotypic data of 36 tag single nucleotide polymorphisms (SNPs). Results: Although there was no association between genotyped SNPs and CTEV, a gene-environment interaction signal between SNP rs6455357 and maternal drinking was identified. Furthermore, significant heterogeneity was identified for this interaction signal when stratified by maternal drinking. For subjects with never maternal drinking, the A allele of SNP rs6455357 was significantly associated with a decreased risk of CTEV. In contrast, the A allele was associated with an increased risk of CTEV in the "occasional" and "often" groups. Conclusions: Our results indicate a combined effect of genetics and environmental factors on the etiology of CTEV. This study increases our understanding of the etiology of CETV and provides useful information for genetic counseling for at-risk families for the development of prevention programs and improved management.
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Affiliation(s)
- Jianwu Zhao
- Department of Hand and Foot Microsurgery, The First Hospital of Yulin, Yulin, China
| | - Fei Cai
- Department of Hand and Foot Microsurgery, The First Hospital of Yulin, Yulin, China
| | - Peng Liu
- Department of Hand and Foot Microsurgery, The First Hospital of Yulin, Yulin, China
| | - Jianjiang Wei
- Department of Hand and Foot Microsurgery, The First Hospital of Yulin, Yulin, China
| | - Qiang Chen
- Department of Hand and Foot Microsurgery, The First Hospital of Yulin, Yulin, China
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16
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Melov SJ, Shetty PS, Pasupathy D, Kirby A, Sholler GF, Winlaw DS, Alahakoon TI. Selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitors and epidemiological characteristics associated with prenatal diagnosis of congenital heart disease. Prenat Diagn 2020; 41:35-42. [PMID: 33067884 DOI: 10.1002/pd.5846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/12/2020] [Accepted: 10/13/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Identify early pregnancy associations of congenital heart disease (CHD) in a multiethnic cohort. METHODS This retrospective observational cohort study compared the general obstetric population to women who gave birth at a referral centre in Australia between 2012 and 2017, after 20 weeks' of gestation, with a pregnancy affected by CHD. We defined mood disorder and anxiety as a history of self-reported or medically diagnosed anxiety, depression, postpartum depression or bipolar disorder. RESULTS We compared epidemiological factors between 30 842 general obstetric patients and 470 obstetric patients with a foetus affected by CHD. Multivariate analysis showed independent associations between CHD and use of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) in the first trimester (relative risk [RR] 4.14, 95% CI 2.58-6.65), history of anxiety or mood disorder with no SSRI/SNRI first trimester (RR 2.20, 95% CI 1.77-2.74), folate and/or pregnancy multivitamin use in the first trimester (RR 0.69, 95% CI 0.55-0.87) and increased risk with maternal age >40 years (RR 2.30, 95% CI 1.57-3.38). CONCLUSIONS Our data show maternal mood disorders with and without SSRI or SNRI use, maternal age >40 years and lack of multivitamin/folate use to be independently associated with CHD in pregnancy.
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Affiliation(s)
- Sarah J Melov
- Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia.,Discipline of Obstetrics Gynaecology and Neonatology, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Prayatna Singh Shetty
- Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia
| | - Dharmintra Pasupathy
- Discipline of Obstetrics Gynaecology and Neonatology, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Women and Children's Health, School of Life Course Sciences, King's College, London, UK
| | - Adrienne Kirby
- Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Gary F Sholler
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Heart Centre for Children, The Children's Hospital at Westmead, The Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - David S Winlaw
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,The Heart Centre for Children, The Children's Hospital at Westmead, The Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Thushari I Alahakoon
- Westmead Institute for Maternal and Fetal Medicine, Women's and Newborn Health, Westmead Hospital, Westmead, New South Wales, Australia.,Discipline of Obstetrics Gynaecology and Neonatology, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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17
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Chen Z, Li S, Guo L, Peng X, Liu Y. Prenatal alcohol exposure induced congenital heart diseases: From bench to bedside. Birth Defects Res 2020; 113:521-534. [PMID: 32578335 DOI: 10.1002/bdr2.1743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/27/2022]
Abstract
Alcohol consumption is increasing worldwide. Many child-bearing-aged women consume alcohol during pregnancy, intentionally or unintentionally, thereby increasing the potential risk for severe congenital diseases. Congenital heart disease (CHD) is the most common birth defect worldwide and can result from both hereditary and acquired factors. Prenatal alcohol exposure (PAE) is considered a key factor that leads to teratogenesis in CHD and its specific phenotypes, especially defects of the cardiac septa, cardiac valves, cardiac canals, and great arteries, adjacent to the chambers, both in animal experiments and clinical retrospective studies. The mechanisms underlying CHD and its phenotypes caused by PAE are associated with changes in retinoic acid biosynthesis and its signaling pathway, apoptosis and defective function of cardiac neural crest cells, disturbance of the Wntβ-catenin signaling pathway, suppression of bone morphogenetic protein (BMP) signaling, and other epigenetic mechanisms. Drug supplements and early diagnosis can help prevent PAE from inducing CHDs.
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Affiliation(s)
- Zhiyan Chen
- Department of Basic Medical Sciences, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China.,Department of Research, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Sheng Li
- Department of Basic Medical Sciences, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China.,Department of Research, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Linghong Guo
- Department of Pharmacology, West China School of Basic Sciences & Forensic Medicine; Animal Research Institute, Sichuan University, Chengdu, Sichuan, China
| | - Xu Peng
- Department of Pharmacology, West China School of Basic Sciences & Forensic Medicine; Animal Research Institute, Sichuan University, Chengdu, Sichuan, China
| | - Yin Liu
- Department of Basic Medical Sciences, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China.,Department of Research, Zigong First People's Hospital, Zigong, Sichuan, China.,Department of Pharmacology, West China School of Basic Sciences & Forensic Medicine; Animal Research Institute, Sichuan University, Chengdu, Sichuan, China.,Department of Anesthesiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
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Li Q, Yao H, Gu GJ, Ma ZH, Wu DK, Wu G, Chen YM, Luo TN. [Association between maternal alcohol consumption and risk of congenital heart disease in offspring: a Meta analysis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:643-650. [PMID: 32571466 PMCID: PMC7390211 DOI: 10.7499/j.issn.1008-8830.1912083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To study the association between maternal alcohol consumption and the risk of congenital heart disease (CHD) in offspring. METHODS PubMed, Cochrane Library, Web of Science, Google Scholar, China Biology Medicine disc, Wanfang Database, CNKI Database, and Weipu Database were searched for the articles on the association between maternal alcohol consumption and congenital heart disease in offspring. These articles were published up to November 30, 2019. A random effects model or a fixed effects model was used for the pooled analysis of the results of each study, and then the pooled effective value and its 95%CI were calculated. A subgroup analysis was performed to explore heterogeneous regulators. Funnel plots and an Egger's test were used to assess publication bias. RESULTS A total of 4 409 articles were searched, and 55 articles were finally included in this analysis, among which there were 6 cohort studies and 49 case-control studies. The Meta analysis showed heterogeneity across all studies (I2=74%, P<0.01). The random effects model showed that maternal alcohol consumption was associated with CHD in offspring, with an OR of 1.18 (95%CI: 1.09-1.28). The Egger's test showed a certain degree of publication bias (P<0.05), and after adjustment, the pooled OR of CHD in offspring was 1.10 (95%CI: 1.01-1.21). CONCLUSIONS Maternal alcohol consumption may increase the risk of CHD in offspring.
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Affiliation(s)
- Qi Li
- Xiangxi Center for Disease Prevention and Control, Jishou, Hunan 416000, China.
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19
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Kalisch-Smith JI, Ved N, Sparrow DB. Environmental Risk Factors for Congenital Heart Disease. Cold Spring Harb Perspect Biol 2020; 12:a037234. [PMID: 31548181 PMCID: PMC7050589 DOI: 10.1101/cshperspect.a037234] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Congenital heart disease (CHD) has many forms and a wide range of causes. Clinically, it is important to understand the causes. This allows estimation of recurrence rate, guides treatment options, and may also be used to formulate public health advice to reduce the population prevalence of CHD. The recent advent of sophisticated genetic and genomic methods has led to the identification of more than 100 genes associated with CHD. However, despite these great strides, to date only one-third of CHD cases have been shown to have a simple genetic cause. This is because CHD can also be caused by oligogenic factors, environmental factors, and/or gene-environment interaction. Although solid evidence for environmental causes of CHD have been available for almost 80 years, it is only very recently that the molecular mechanisms for these risk factors have begun to be investigated. In this review, we describe the most important environmental CHD risk factors, and what is known about how they cause CHD.
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Affiliation(s)
| | - Nikita Ved
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, Oxfordshire OX1 3PT, United Kingdom
| | - Duncan Burnaby Sparrow
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, Oxfordshire OX1 3PT, United Kingdom
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20
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AIUM Practice Parameter for the Performance of Fetal Echocardiography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:E5-E16. [PMID: 31846540 DOI: 10.1002/jum.15188] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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N-Acetylcysteine prevents the decreases in cardiac collagen I/III ratio and systolic function in neonatal mice with prenatal alcohol exposure. Toxicol Lett 2019; 315:87-95. [PMID: 31425726 DOI: 10.1016/j.toxlet.2019.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/13/2019] [Accepted: 08/15/2019] [Indexed: 12/23/2022]
Abstract
Prenatal alcohol exposure (PAE) is often associated with congenital heart defects, most commonly septal, valvular, and great vessel defects. However, there have been no known studies on whether PAE affects the resulting fibroblast population after development, and whether this has any consequences in the postnatal period. Our previous study focused on the effects of PAE on the postnatal fibroblast population, which translated into changes in cardiac extracellular matrix (ECM) composition and cardiac function in the neonatal heart. Moreover, our lab has previously demonstrated that alcohol-induced fibrosis is mediated by oxidative stress mechanisms in adult rat hearts following chronic alcohol exposure. Thus, we hypothesize that PAE alters cardiac ECM composition that persists into the postnatal period, leading to cardiac dysfunction, and these effects are prevented by antioxidant treatment. To investigate these effects, pregnant mice were intraperitoneally injected with 2.9 g EtOH/kg body weight on gestation days 6.75 and 7.25. Controls were injected with vehicle saline. Randomly selected dams in both groups were then treated with 100 mg/kg body weight of the antioxidant N-acetylcysteine (NAC) immediately after EtOH or vehicle administration. Left ventricular (LV) chamber dimension and function were assessed in sedated animals on neonatal day 5 using echocardiography. Ejection fraction decreased in the PAE group. NAC treatment prevented this depression of systolic function in PAE neonates. Hearts were analyzed for expression of fibroblast activation markers. Alpha smooth muscle actin (α-SMA) increased in PAE neonatal hearts, and this increase was prevented by NAC treatment. In PAE pups, collagen I decreased, but collagen III expression increased compared to saline animals; the overall collagen I/III ratio significantly decreased. When PAE mice were treated with NAC, collagen I/III ratio did not change. Overall, our data demonstrate that prenatal alcohol exposure produces changes in collagen subtype in neonatal cardiac ECM and a decline in systolic function, and these adverse effects were prevented by NAC treatment.
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22
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Forestieri NE, Desrosiers TA, Freedman SF, Aylsworth AS, Voltzke K, Olshan AF, Meyer RE. Risk factors for primary congenital glaucoma in the National Birth Defects Prevention Study. Am J Med Genet A 2019; 179:1846-1856. [DOI: 10.1002/ajmg.a.61296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 02/05/2019] [Accepted: 07/03/2019] [Indexed: 02/04/2023]
Affiliation(s)
- Nina E. Forestieri
- North Carolina Birth Defects Monitoring Program, State Center for Health Statistics Raleigh North Carolina
| | - Tania A. Desrosiers
- Department of EpidemiologyGillings School of Global Public Health, University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Sharon F. Freedman
- Department of Ophthalmology and PediatricsDuke University Medical Center Durham North Carolina
| | - Arthur S. Aylsworth
- Department of Pediatrics and GeneticsUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Kristin Voltzke
- Department of EpidemiologyGillings School of Global Public Health, University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Andrew F. Olshan
- Department of EpidemiologyGillings School of Global Public Health, University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Robert E. Meyer
- North Carolina Birth Defects Monitoring Program, State Center for Health Statistics Raleigh North Carolina
- Department of Maternal and Child HealthGillings School of Global Public Health, University of North Carolina at Chapel Hill Chapel Hill North Carolina
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23
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Zhu Y, Xu C, Zhang Y, Xie Z, Shu Y, Lu C, Mo X. Associations of trace elements in blood with the risk of isolated ventricular septum defects and abnormal cardiac structure in children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:10037-10043. [PMID: 30746621 DOI: 10.1007/s11356-019-04312-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/22/2019] [Indexed: 06/09/2023]
Abstract
This study sought to determine correlations between the presence of isolated ventricular septum defects (VSDs) and blood levels of trace elements. A total of 144 patients with VSDs and 144 controls were recruited for cross-sectional assessment of trace elements and examination of cardiac structures in the Jiangsu and Anhui provinces between 2016 and 2018. Logistic regression was performed to explore the relationships between VSDs and trace elements. Additionally, general linear regression models were used to investigate relationships between trace elements and echocardiography indicators. Relative to the lowest zinc (Zn) concentrations, the highest Zn concentrations may be associated with lower odds of VSD development (OR = 0.03, 95% confidence interval [CI] = 0.01-0.29, P < 0.001). However, no significant relationships between the concentrations of other trace elements and the risk of VSD were identified. Aorta (AO) diameters were markedly smaller in the VSD group, whereas no significant between-group differences were observed for other echocardiography indicators. After adjusting for age and gender, linear regression indicated a significant association between Zn level and mean AO diameter (beta coefficient = 0.247, 95% CI = 0.126-0.367). Zn deficiency was observed in patients with isolated VSDs. Further work to explore the mechanisms by which Zn deficiency leads to VSDs is warranted.
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Affiliation(s)
- Yu Zhu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Cheng Xu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Yuxi Zhang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Zongyun Xie
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Yaqin Shu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Changgui Lu
- Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
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Chevalier G, Rakza T, Joriot S, Gautier S, Houfflin-Debarge V. Hydrops and fetal hypoplastic left heart: An unexpected improvement after cessation of maternal polysubstance abuse. J Gynecol Obstet Hum Reprod 2018; 47:573-575. [PMID: 30194993 DOI: 10.1016/j.jogoh.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Affiliation(s)
- G Chevalier
- Department of Obstetrics, Jeanne de Flandre Hospital, University Hospital of Lille, Lille 59000, France.
| | - T Rakza
- Department of Neonatology, Jeanne de Flandre Hospital, University Hospital of Lille, Lille 59000, France
| | - S Joriot
- Department of Pediatric Neurology, Jeanne de Flandre Hospital, University Hospital of Lille, Lille 59000, France
| | - S Gautier
- Department of Medical Pharmacology, Pharmacovigilance Regional Center, University Hospital of Lille, Lille 59000, France
| | - V Houfflin-Debarge
- Department of Obstetrics, Jeanne de Flandre Hospital, University Hospital of Lille, Lille 59000, France; EA4489, Perinatal Environment and Health, Faculty of Medicine, Lille University, Lille 59000, France
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Tang X, Eberhart JK, Cleves MA, Li J, Li M, MacLeod S, Nembhard WN, Hobbs CA. PDGFRA gene, maternal binge drinking and obstructive heart defects. Sci Rep 2018; 8:11083. [PMID: 30038270 PMCID: PMC6056529 DOI: 10.1038/s41598-018-29160-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 06/15/2018] [Indexed: 01/06/2023] Open
Abstract
Obstructive heart defects (OHDs) are a major health concern worldwide. The platelet-derived growth factor (PDGF) genes are known to have regulatory functions that are essential for proper heart development. In a zebrafish model, Pdgfra was further demonstrated to interact with ethanol during craniofacial development. In this article, we investigated interactions between variants in PDGF genes and periconceptional alcohol exposure on the risk of OHDs by applying log-linear models to 806 OHD case and 995 control families enrolled in the National Birth Defects Prevention Study. The interactions between four variants in PDGFA and maternal binge drinking reached a nominal significance level. The maternal T allele of rs869978 was estimated to increase OHD risk among women who binge drink, while infant genotypes of rs2291591, rs2228230, rs1547904, and rs869978 may reduce the risk. Although none of these associations remain statistically significant after multiple testing adjustment and the estimated maternal effect may be influenced by unknown confounding factors, such as maternal smoking, these findings are consistent with previous animal studies supporting potential interactions between the PDGFRA gene and maternal alcohol exposure. Replication studies with larger sample sizes are needed to further elucidate this potential interplay and its influence on OHD risks.
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Affiliation(s)
- Xinyu Tang
- Biostatistics Program, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, 72202, USA
| | - Johann K Eberhart
- Department of Molecular and Cell and Developmental Biology, Institute for Cellular and Molecular Biology and Institute for Neuroscience, University of Texas, Austin, 78712, USA
| | - Mario A Cleves
- Biostatistics Program, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, 72202, USA
| | - Jingyun Li
- Biostatistics Program, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, 72202, USA
| | - Ming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University at Bloomington, Bloomington, 47405, USA
| | - Stewart MacLeod
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, 72202, USA
| | - Wendy N Nembhard
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, 72202, USA
| | - Charlotte A Hobbs
- Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, 72202, USA.
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Sarmah S, Muralidharan P, Marrs JA. Common congenital anomalies: Environmental causes and prevention with folic acid containing multivitamins. ACTA ACUST UNITED AC 2016; 108:274-286. [PMID: 27718306 DOI: 10.1002/bdrc.21138] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 09/23/2016] [Indexed: 12/13/2022]
Abstract
Congenital anomalies, congenital defects, or birth defects are significant causes of death in infants. The most common congenital defects are congenital heart defects (CHDs) and neural tube defects (NTDs). Defects induced by genetic mutations, environmental exposure to toxins, or a combination of these effects can result in congenital malformations, leading to infant death or long-term disabilities. These defects produce significant mortality and morbidity in the affected individuals, and families are affected emotional and financially. Also, society is impacted on many levels. Congenital anomalies may be reduced by dietary supplements of folic acid and other vitamins. Here, we review the evidence for specific roles of toxins (alcohol, cigarette smoke) in causing common severe congenital anomalies like CHDs, NTDs, and ocular defects. We also review the evidence for beneficial effects for dietary supplementation, and highlight gaps in our knowledge, where research may contribute to additional benefits of intervention that can reduce birth defects. Extensive discussion of common severe congenital anomalies (CHDs, NTDs, and ocular defects) illustrates the effects of diet on the frequency and severity of these defects. Birth Defects Research (Part C) 108:274-286, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Swapnalee Sarmah
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, 46202.
| | - Pooja Muralidharan
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, 46202
| | - James A Marrs
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, 46202.
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Linask KK, Han M. Acute alcohol exposure during mouse gastrulation alters lipid metabolism in placental and heart development: Folate prevention. ACTA ACUST UNITED AC 2016; 106:749-60. [PMID: 27296863 PMCID: PMC5094567 DOI: 10.1002/bdra.23526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/29/2016] [Accepted: 04/28/2016] [Indexed: 12/20/2022]
Abstract
Background Embryonic acute exposure to ethanol (EtOH), lithium, and homocysteine (HCy) induces cardiac defects at the time of exposure; folic acid (FA) supplementation protects normal cardiogenesis (Han et al., 2009, 2012; Serrano et al., 2010). Our hypothesis is that EtOH exposure and FA protection relate to lipid and FA metabolism during mouse cardiogenesis and placentation. Methods On the morning of conception, pregnant C57BL/6J mice were placed on either of two FA‐containing diets: a 3.3 mg health maintenance diet or a high FA diet of 10.5 mg/kg. Mice were injected a binge level of EtOH, HCy, or saline on embryonic day (E) 6.75, targeting gastrulation. On E15.5, cardiac and umbilical blood flow were examined by ultrasound. Embryonic cardiac tissues were processed for gene expression of lipid and FA metabolism; the placenta and heart tissues for neutral lipid droplets, or for medium chain acyl‐dehydrogenase (MCAD) protein. Results EtOH exposure altered lipid‐related gene expression on E7.5 in comparison to control or FA‐supplemented groups and remained altered on E15.5 similarly to changes with HCy, signifying FA deficiency. In comparison to control tissues, the lipid‐related acyl CoA dehydrogenase medium length chain gene and its protein MCAD were altered with EtOH exposure, as were neutral lipid droplet localization in the heart and placenta. Conclusion EtOH altered gene expression associated with lipid and folate metabolism, as well as neutral lipids, in the E15.5 abnormally functioning heart and placenta. In comparison to controls, the high FA diet protected the embryo and placenta from these effects allowing normal development. Birth Defects Research (Part A) 106:749–760, 2016. © 2016 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Kersti K Linask
- Department of Pediatrics, USF Morsani College of Medicine, Tampa and St. Petersburg, Florida.
| | - Mingda Han
- Department of Pediatrics, USF Morsani College of Medicine, Tampa and St. Petersburg, Florida
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Miller M, Bailey B, Govindarajah V, Levin L, Metzger T, Pinney SM, Leung YK, Ho SM. A community survey on knowledge of the impact of environmental and epigenetic factors on health and disease. Perspect Public Health 2016; 136:345-352. [PMID: 26941233 DOI: 10.1177/1757913916630341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIM An outreach effort was designed to survey breast cancer survivors, supporters and their families and friends with respect to their interest in, and knowledge of, the potential impact of the environment and epigenetics on health. METHODS Two nearly identical questionnaires (one for adolescents and one for adults) were designed to gauge the perception of this community as to whether the environment impacts health and cancer risk through processes other than genetics. The questionnaires were filled out at casual social gatherings, fundraisers and wellness campaigns as well as in schools (730 participants). The differences among correct (scientific consensus) versus other responses (incorrect and not known) were evaluated. Each answer was first analysed individually and then grouped into one of three categories (diet, inheritance and environment) with age, race and gender. Differences for each response, question or group were compared by repeated measures analysis of variance. RESULTS Respondents generally acknowledged that many factors could be associated with breast cancer although answers to key questions related to epigenetics based on diet, inheritance and environment were often incorrect or not known. The adult participants tended to answer more questions correctly than adolescents did. The majority of participants preferred the Internet as a major source for obtaining further information. CONCLUSION The growing awareness and educational needs for adolescents may bring new paradigm-related environmental risk factors, which may minimise negative epigenetic outcome in subsequent generations. There is an educational opportunity, especially using electronic media, for public education concerning the impact of the environment on human health.
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Affiliation(s)
- Marian Miller
- Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | | | - Vinothini Govindarajah
- Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Linda Levin
- Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | | | - Susan M Pinney
- Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati, Center for Environmental Genetics, Cincinnati, OH, USA
| | - Yuet-Kin Leung
- Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, Center for Environmental Genetics, University of Cincinnati, Cincinnati, OH, USA
| | - Shuk-Mei Ho
- Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, USA; Center for Environmental Genetics, University of Cincinnati, University of Cincinnati Cancer Center, Cincinnati, OH, USA; Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
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Carvalho ICS, Dutra TP, De Andrade DP, Balducci I, Pacheco-Soares C, Rocha RFD. High doses of alcohol during pregnancy cause DNA damages in osteoblasts of newborns rats. ACTA ACUST UNITED AC 2015; 106:122-32. [DOI: 10.1002/bdra.23468] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Isabel Chaves Silva Carvalho
- Institute of Science and Technology, UNESP - Univ Estadual Paulista, Sao Jose dos Campos (SP), Department of Biosciences and Oral Diagnosis; Sao Jose dos Campos; Sao Paulo Brazil
| | - Tamires Pereira Dutra
- Institute of Science and Technology, UNESP - Univ Estadual Paulista, Sao Jose dos Campos (SP), Department of Biosciences and Oral Diagnosis; Sao Jose dos Campos; Sao Paulo Brazil
| | - Dennia Perez De Andrade
- Institute of Research and Development - IP&D, Universidade do Vale do Paraíba - UNIVAP, Laboratory Dynamics of Cellular Compartments; Sao Jose dos Campos; Sao Paulo Brazil
| | - Ivan Balducci
- Institute of Science and Technology, UNESP - Univ Estadual Paulista, Sao Jose dos Campos (SP), Department of Social Science and Pediatric Dentristy; Sao Jose dos Campos; Sao Paulo Brazil
| | - Cristina Pacheco-Soares
- Institute of Research and Development - IP&D, Universidade do Vale do Paraíba - UNIVAP, Laboratory Dynamics of Cellular Compartments; Sao Jose dos Campos; Sao Paulo Brazil
| | - Rosilene Fernandes da Rocha
- Institute of Science and Technology, UNESP - Univ Estadual Paulista, Sao Jose dos Campos (SP), Department of Biosciences and Oral Diagnosis; Sao Jose dos Campos; Sao Paulo Brazil
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