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Lee KS, Choi YJ, Cho J, Lee H, Lee H, Park SJ, Park JS, Hong YC. Environmental and Genetic Risk Factors of Congenital Anomalies: an Umbrella Review of Systematic Reviews and Meta-Analyses. J Korean Med Sci 2021; 36:e183. [PMID: 34282604 PMCID: PMC8289720 DOI: 10.3346/jkms.2021.36.e183] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/15/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of congenital anomalies in newborns in South Korea was 272.9 per 100,000 in 2005, and 314.7 per 100,000 in 2006. In other studies, the prevalence of congenital anomalies in South Korea was equivalent to 286.9 per 10,000 livebirths in 2006, while it was estimated 446.3 per 10,000 births during the period from 2008 to 2014. Several systematic reviews and meta-analyses analyzing the factors contributing to congenital anomalies have been reported, but comprehensive umbrella reviews are lacking. METHODS We searched PubMed, Google Scholar, Cochrane, and EMBASE databases up to July 1, 2019, for systematic reviews and meta-analyses that investigated the effects of environmental and genetic factors on any type of congenital anomalies. We categorized 8 subgroups of congenital anomalies classified according to the 10th revision of the International Statistical Classification of Diseases (ICD-10). Two researchers independently searched the literature, retrieved the data, and evaluated the quality of each study. RESULTS We reviewed 66 systematic reviews and meta-analyses that investigated the association between non-genetic or genetic risk factors and congenital anomalies. Overall, 269 associations and 128 associations were considered for environmental and genetic risk factors, respectively. Congenital anomalies based on congenital heart diseases, cleft lip and palate, and others were associated with environmental risk factors based on maternal exposure to environmental exposures (air pollution, toxic chemicals), parental smoking, maternal history (infectious diseases during pregnancy, pregestational and gestational diabetes mellitus, and gestational diabetes mellitus), maternal obesity, maternal drug intake, pregnancy through artificial reproductive technologies, and socioeconomic factors. The association of maternal alcohol or coffee consumption with congenital anomalies was not significant, and maternal folic acid supplementation had a preventive effect on congenital heart defects. Genes or genetic loci associated with congenital anomalies included MTHFR, MTRR and MTR, GATA4, NKX2-5, SRD5A2, CFTR, and 1p22 and 20q12 anomalies. CONCLUSION This study provides a wide perspective on the distribution of environmental and genetic risk factors of congenital anomalies, thus suggesting future studies and providing health policy implications.
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Affiliation(s)
- Kyung Shin Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Jung Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jinwoo Cho
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hyunji Lee
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Heejin Lee
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Soo Jin Park
- Department of Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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El-Borm HT, Abd El-Gaber AS. Effect of prenatal exposure of green tea extract on the developing central nervous system of rat fetuses; histological, immune-histochemical and ultrastructural studies. Saudi J Biol Sci 2021; 28:4704-4716. [PMID: 34354458 PMCID: PMC8324952 DOI: 10.1016/j.sjbs.2021.04.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022] Open
Abstract
Although, several health benefits were associated with green tea, these effects may be beneficial up to a certain dose. Higher doses of green tea may cause several adverse effects. So, there is a need to test the potential negative effects of green tea during pregnancy. This study was designated to evaluate the effect of prenatal exposure of green tea extract on the development of the central nervous system of 20-day old rat fetuses. The pregnant rats were divided into 4 groups; the control group (received distal water) and the other 3 groups received green tea extract at different doses (200, 600 & 1000 mg/kg/day, respectively) from the 6th to 15th day of gestation i.e., during the organogenesis phase of development. Cerebral cortex, cerebellum and spinal cord specimens were subjected to histological, immunohistochemical and ultrastructure investigations. The body weight of both mothers and fetuses was significantly decreased in the groups that received 600 and 1000 mg green tea extract. Also, the neuronal tissues displayed various signs of degeneration which were evident with the 600 and 1000 mg doses. Green tea extract also increases the glial fibrillary acidic protein (GFAP) and decreases the proliferating cell nuclear antigen (PCNA) which were directly proportional with increasing the dose. Administration of green tea extract during rat organogenesis period induced various histological, immunohistochemical and ultrastructural degenerative changes in the cerebral cortex, cerebellum and spinal cord of 20-day old rat fetuses. These deleterious changes were directly proportional to increasing the green tea extract dose. Thus, it should be stressed that the effect of green tea is dose-dependent and therefore it can be either beneficial or adverse.
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Key Words
- (CNS), Central nervous system
- (CP), cortical plate
- (EGCG), Epigallocatechin-3-gallate
- (GFAP), Glial fibrillary acidic protein
- (GTE), Green tea extract
- (IZ), Intermediate zone
- (MZ), marginal zone
- (PCNA), Proliferating cell nuclear antigen
- (SVZ), Subventricular zone
- (VZ), ventricular zone
- CNS
- GFAP
- Green tea
- Organogenesis
- PCNA
- Ultrastructure
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Affiliation(s)
- Hend T El-Borm
- Lecturer of Vertebrates, Comparative Anatomy and Embryology-Zoology Department-Faculty of Science-Menoufia University, Egypt
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Abstract
Numerous studies have examined the association between maternal caffeine consumption and infant and childhood health outcomes and the results have been inconsistent. The study of maternal caffeine intake and infant and childhood health outcomes is prone to methodologic challenges. In this review, we examine the existing evidence juxtaposed with the epidemiologic design challenges that color the interpretation of the study results presented. In light of methodologic/interpretation challenges, it seems reasonable to infer that exposure to low levels of caffeine is probably not associated with substantial infant and childhood adversities. However, more research is needed using well designed studies that address methodologic challenges.
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Affiliation(s)
| | - Alan Leviton
- Boston Children's Hospital & Harvard Medical School, Brookline, MA, USA
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Caffeine Intake During Pregnancy and Neonatal Anthropometric Parameters. Nutrients 2019; 11:nu11040806. [PMID: 30970673 PMCID: PMC6520888 DOI: 10.3390/nu11040806] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/27/2019] [Accepted: 04/03/2019] [Indexed: 11/17/2022] Open
Abstract
Caffeine is a psychoactive substance that may affect the normal course of pregnancy, therefore its intake during that time should not exceed 200 mg/day. The aim of this study was to evaluate caffeine intake among pregnant women from the Warsaw region. The study was conducted among 100 pregnant women who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Caffeine intake from coffee, tea, and energy drinks was measured using a questionnaire. Direct interviewing was used, with all interviews conducted by the same dietitian. Multiple regression analysis was used to investigate the relationship between caffeine intake and anthropometric measurements of the newborns. Mean caffeine intake among pregnant women was 68 ± 51 mg/day. Only 2% of the respondents exceeded the safe dose of 200 mg. Tea (mostly black) was the source of 63% of all caffeine. No relationships were found between caffeine intake and neonatal weight, length, or head and chest circumference (p > 0.05). Caffeine intake in our study population was relatively low and did not negatively affect fetal growth.
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Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ 2017; 359:j5024. [PMID: 29167102 PMCID: PMC5696634 DOI: 10.1136/bmj.j5024] [Citation(s) in RCA: 429] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objectives To evaluate the existing evidence for associations between coffee consumption and multiple health outcomes.Design Umbrella review of the evidence across meta-analyses of observational and interventional studies of coffee consumption and any health outcome.Data sources PubMed, Embase, CINAHL, Cochrane Database of Systematic Reviews, and screening of references.Eligibility criteria for selecting studies Meta-analyses of both observational and interventional studies that examined the associations between coffee consumption and any health outcome in any adult population in all countries and all settings. Studies of genetic polymorphisms for coffee metabolism were excluded.Results The umbrella review identified 201 meta-analyses of observational research with 67 unique health outcomes and 17 meta-analyses of interventional research with nine unique outcomes. Coffee consumption was more often associated with benefit than harm for a range of health outcomes across exposures including high versus low, any versus none, and one extra cup a day. There was evidence of a non-linear association between consumption and some outcomes, with summary estimates indicating largest relative risk reduction at intakes of three to four cups a day versus none, including all cause mortality (relative risk 0.83 (95% confidence interval 0.79 to 0.88), cardiovascular mortality (0.81, 0.72 to 0.90), and cardiovascular disease (0.85, 0.80 to 0.90). High versus low consumption was associated with an 18% lower risk of incident cancer (0.82, 0.74 to 0.89). Consumption was also associated with a lower risk of several specific cancers and neurological, metabolic, and liver conditions. Harmful associations were largely nullified by adequate adjustment for smoking, except in pregnancy, where high versus low/no consumption was associated with low birth weight (odds ratio 1.31, 95% confidence interval 1.03 to 1.67), preterm birth in the first (1.22, 1.00 to 1.49) and second (1.12, 1.02 to 1.22) trimester, and pregnancy loss (1.46, 1.06 to 1.99). There was also an association between coffee drinking and risk of fracture in women but not in men.Conclusion Coffee consumption seems generally safe within usual levels of intake, with summary estimates indicating largest risk reduction for various health outcomes at three to four cups a day, and more likely to benefit health than harm. Robust randomised controlled trials are needed to understand whether the observed associations are causal. Importantly, outside of pregnancy, existing evidence suggests that coffee could be tested as an intervention without significant risk of causing harm. Women at increased risk of fracture should possibly be excluded.
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Affiliation(s)
- Robin Poole
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - Oliver J Kennedy
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - Paul Roderick
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - Jonathan A Fallowfield
- Medical Research Council/University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, EH16 4TJ, UK
| | - Peter C Hayes
- Medical Research Council/University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, EH16 4TJ, UK
| | - Julie Parkes
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
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Grosso G, Godos J, Galvano F, Giovannucci EL. Coffee, Caffeine, and Health Outcomes: An Umbrella Review. Annu Rev Nutr 2017; 37:131-156. [PMID: 28826374 DOI: 10.1146/annurev-nutr-071816-064941] [Citation(s) in RCA: 305] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To evaluate the associations between coffee and caffeine consumption and various health outcomes, we performed an umbrella review of the evidence from meta-analyses of observational studies and randomized controlled trials (RCTs). Of the 59 unique outcomes examined in the selected 112 meta-analyses of observational studies, coffee was associated with a probable decreased risk of breast, colorectal, colon, endometrial, and prostate cancers; cardiovascular disease and mortality; Parkinson's disease; and type-2 diabetes. Of the 14 unique outcomes examined in the 20 selected meta-analyses of observational studies, caffeine was associated with a probable decreased risk of Parkinson's disease and type-2 diabetes and an increased risk of pregnancy loss. Of the 12 unique acute outcomes examined in the selected 9 meta-analyses of RCTs, coffee was associated with a rise in serum lipids, but this result was affected by significant heterogeneity, and caffeine was associated with a rise in blood pressure. Given the spectrum of conditions studied and the robustness of many of the results, these findings indicate that coffee can be part of a healthful diet.
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Affiliation(s)
- Giuseppe Grosso
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Catania 95123, Italy; .,NNEdPro Global Centre for Nutrition and Health, St. John's Innovation Centre, Cambridge CB4 0WS, United Kingdom
| | - Justyna Godos
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Catania 95123, Italy; .,Biomedical and Biotechnological Sciences, University of Catania, Catania 95124, Italy; ,
| | - Fabio Galvano
- Biomedical and Biotechnological Sciences, University of Catania, Catania 95124, Italy; ,
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115; .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
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Karaman E, Çetin O, Boza B, Alışık M, Erel Ö, Çim N, Yıldızhan R, Şahin HG. Maternal serum thiol/disulfide homeostasis in pregnancies complicated by neural tube defects: report of a preliminary study. J Matern Fetal Neonatal Med 2016; 30:1803-1808. [DOI: 10.1080/14767058.2016.1226795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Erbil Karaman
- Department of Obstetric and Gynecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey and
| | - Orkun Çetin
- Department of Obstetric and Gynecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey and
| | - Barış Boza
- Department of Obstetric and Gynecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey and
| | - Murat Alışık
- Department of Biochemistry, Medical Faculty, Yıldırım Beyazit University, Ankara, Turkey
| | - Özcan Erel
- Department of Biochemistry, Medical Faculty, Yıldırım Beyazit University, Ankara, Turkey
| | - Numan Çim
- Department of Obstetric and Gynecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey and
| | - Recep Yıldızhan
- Department of Obstetric and Gynecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey and
| | - Hanım Güler Şahin
- Department of Obstetric and Gynecology, Medical Faculty, Yuzuncu Yil University, Van, Turkey and
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