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Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects

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 asso...

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Autores principales: Harvey, Drayton C., Baer, Rebecca J., Bandoli, Gretchen, Chambers, Christina D., Jelliffe‐Pawlowski, Laura L., Kumar, S. Ram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238516/
https://www.ncbi.nlm.nih.gov/pubmed/35014860
http://dx.doi.org/10.1161/JAHA.121.022175
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author Harvey, Drayton C.
Baer, Rebecca J.
Bandoli, Gretchen
Chambers, Christina D.
Jelliffe‐Pawlowski, Laura L.
Kumar, S. Ram
author_facet Harvey, Drayton C.
Baer, Rebecca J.
Bandoli, Gretchen
Chambers, Christina D.
Jelliffe‐Pawlowski, Laura L.
Kumar, S. Ram
author_sort Harvey, Drayton C.
collection PubMed
description 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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spelling pubmed-92385162022-06-30 Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects Harvey, Drayton C. Baer, Rebecca J. Bandoli, Gretchen Chambers, Christina D. Jelliffe‐Pawlowski, Laura L. Kumar, S. Ram J Am Heart Assoc JAHA Spotlight on Pregnancy and its Impact on Maternal and Offspring Cardiovascular Health 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. John Wiley and Sons Inc. 2022-01-11 /pmc/articles/PMC9238516/ /pubmed/35014860 http://dx.doi.org/10.1161/JAHA.121.022175 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle JAHA Spotlight on Pregnancy and its Impact on Maternal and Offspring Cardiovascular Health
Harvey, Drayton C.
Baer, Rebecca J.
Bandoli, Gretchen
Chambers, Christina D.
Jelliffe‐Pawlowski, Laura L.
Kumar, S. Ram
Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects
title Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects
title_full Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects
title_fullStr Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects
title_full_unstemmed Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects
title_short Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects
title_sort association of alcohol use diagnostic codes in pregnancy and offspring conotruncal and endocardial cushion heart defects
topic JAHA Spotlight on Pregnancy and its Impact on Maternal and Offspring Cardiovascular Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238516/
https://www.ncbi.nlm.nih.gov/pubmed/35014860
http://dx.doi.org/10.1161/JAHA.121.022175
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