Authors: Laura J Lee Philip J Lupo
Publish Date: 2012/08/12
Volume: 34, Issue: 2, Pages: 398-407
Abstract
Although a previous metaanalysis indicated that maternal smoking during pregnancy increased the risk of congenital heart defects CHD in offspring the effect of smoking on individual CHD subtypes was not determined Because CHDs are anatomically clinically epidemiologically and developmentally heterogeneous the authors conducted a systematic review and metaanalysis of the association between maternal smoking during pregnancy and the risk of CHDs including CHD subtypes among offspring Two types of summary relative risk RR estimates any smoking vs no smoking and increasing categories of smoking ie light medium and heavy were calculated for CHDs as a group and for a number of CHD subtypes using both fixed and randomeffects models Random effects estimates were reported if there was evidence of heterogeneity among the studies Consistent with the previous metaanalysis the authors observed a positive association between maternal smoking during pregnancy and the risk of CHDs as a group RR 111 95 confidence interval CI 102–121 number of cases n = 18282 Additionally women who smoked during pregnancy were more likely to have a child with 12 71 of 17 CHD subtypes analyzed compared with women who did not smoke The highest risk was for septal defects as a group RR 144 95 CI 116–179 n = 2977 The evidence of dose response was observed for septal defects as a group atrial septal defects and atrioventricular septal defects This systematic review and metaanalysis suggests that maternal smoking is modestly associated with an increased risk of CHDs and some CHD subtypesThe authors thank A J Agopian Laura Mitchell and Darryl Nousome for their assistance in the preparation of this article This project was supported by the American Heart Association P J Lupo 10BGIA3060022 It also was supported in part by the NIOSH Southwest Center for Occupational Environmental Health Training Grant T42OH008421
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