Is maternal smoking during pregnancy associated with an increased risk of congenital heart defects among offspring? A systematic review and meta-analysis of observational studies

2016 ◽  
Vol 30 (6) ◽  
pp. 645-657 ◽  
Author(s):  
Dongyu Zhang ◽  
Hao Cui ◽  
Long Zhang ◽  
Yanjie Huang ◽  
Jun Zhu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Maternal Smoking ◽  
Observational Studies ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
Smoking During Pregnancy ◽  
Increased Risk ◽  
Maternal Smoking During Pregnancy

Abstract P140: Maternal Smoking During Pregnancy and Risk of Congenital Heart Defects: A Systematic Review and A Meta-Analysis

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura Lee ◽  
Philip Lupo
Keyword(s):  
Congenital Heart Defects ◽  
Maternal Smoking ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Ventricular Septal Defects ◽  
Smoking During Pregnancy ◽  
Septal Defects ◽  
Maternal Smoking During Pregnancy

Objective: Congenital heart defects (CHDs) are the most common group of structural malformations occurring in approximately 1 out of every 100 births. In addition to being the most prevalent birth defect, CHDs are the leading cause of death due to congenital malformations. Despite their prevalence and clinical importance, little is known about the etiology of CHDs, and there are currently no strategies for reducing their prevalence. Maternal smoking during pregnancy has been suggested as a potential risk factor for congenital heart defects, but the evidence is inconclusive. We systematically reviewed epidemiological studies and conducted a meta-analysis of the association between maternal cigarette smoking during pregnancy and the risk of CHDs among the infants. Methods: From a search of published literature through July 2011, we extracted 35 original human epidemiological studies that examined the association between maternal smoking during pregnancy (including a month before conception) and the risk of CHDs in offspring. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted from each study or calculated from available data, comparing smoking to no smoking during pregnancy. Summary risk estimates were also calculated for a number of CHDs subtypes (e.g., conotruncal defects, ventricular septal defects) using both fixed- and random-effects models. Random effects estimates were reported if there was evidence of heterogeneity among the studies. Effects of paternal and environmental smoking were not considered in our analysis. Results: We observed statistically significant positive association between maternal smoking anytime during pregnancy and the risk of CHDs (OR = 1.10; 95% CI: 1.01–1.19; number of cases (n) = 19,552). Additionally, we found a positive and significant association between maternal smoking and the risk of conotruncal defects in offspring (OR = 1.14; 95% CI: 1.03–1.26; n = 1953). Although not statistically significant, stronger elevated risks were observed for ventricular septal defects (OR = 1.11; 95% CI: 0.87–1.41; n = 4605) and atrial septal defects (OR = 1.34; 95% CI: 0.97–1.86; n = 565). Conclusion: Our systematic review and meta-analysis suggest maternal smoking is modestly associated with an increased risk of CHDs and some CHDs subtypes. This work adds to the existing body of evidence that implicated maternal smoking during pregnancy as a possible risk factor for CHDs. Future studies should consider evaluating paternal and environmental smoking exposure to better understand the relationship between smoking and CHDs.

scholarly journals Congenital Heart Defects in Monochorionic Twins: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (6) ◽  
pp. 902 ◽  
Author(s):  
Manon Gijtenbeek ◽  
Maryam R. Shirzada ◽  
Arend D. J. Ten Harkel ◽  
Dick Oepkes ◽  
Monique C. Haak
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
Right Ventricular Outflow Tract ◽  
Monochorionic Twins ◽  
Birth Prevalence ◽  
Live Births ◽  
Increased Risk

Monochorionic (MC) twins are at an increased risk of developing congenital heart defects (CHDs) compared to singletons and dichorionic twins. The development of acquired CHDs in this specific group of twins is associated with twin–twin transfusion syndrome (TTTS). We performed a systematic review and meta-analysis to provide an overview of the reported birth prevalence of CHDs in liveborn MC twins with and without TTTS. Twelve studies were included in this review. Compared to the reference population, MC twins were 6.3 times more likely to be born with a CHD (59.3 per 1000 liveborn twins; relative risk (RR) 6.3; 95% confidence interval (CI): 4.4–9.1), and TTTS twins had a 12-fold increased risk of having a CHD at birth (87.3 per 1000 live births; RR 12.4, 95% CI: 8.6–17.8). The increased incidence of CHDs can mainly be attributed to the risk of right ventricular outflow tract obstruction (35/1000 TTTS twin live births vs. 0.5/1000 singleton live births). We recommend an expert fetal echocardiogram in all MC twins, follow-up scans in the event of TTTS, and a postnatal cardiac evaluation in all TTTS survivors.

scholarly journals Children Born with Congenital Heart Defects and Growth Restriction at Birth: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (9) ◽  
pp. 3056 ◽  
Author(s):  
Ali Ghanchi ◽  
Neil Derridj ◽  
Damien Bonnet ◽  
Nathalie Bertille ◽  
Laurent J. Salomon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Growth Restriction

Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted. Objective: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA). Methods: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model. Results: The pooled proportion of SGA in all CHD was 20% (95% CI 16%–24%) and 14% (95% CI 13%–16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%–37%) for Tetralogy of Fallot to 12% (95% CI 7%–18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010. Conclusion: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.

Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis

The Lancet ◽  
2012 ◽  
Vol 379 (9835) ◽  
pp. 2459-2464 ◽  
Author(s):  
Shakila Thangaratinam ◽  
Kiritrea Brown ◽  
Javier Zamora ◽  
Khalid S Khan ◽  
Andrew K Ewer
Keyword(s):  
Systematic Review ◽  
Pulse Oximetry ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Meta Analysis ◽  
Pulse Oximetry Screening

scholarly journals Maternal smoking during pregnancy and offspring body mass index and overweight: a systematic review and meta-analysis

2019 ◽  
Vol 35 (12) ◽  
Author(s):  
Elma Izze da Silva Magalhães ◽  
Bruno Andrade de Sousa ◽  
Natália Peixoto Lima ◽  
Bernardo Lessa Horta
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Body Mass ◽  
Maternal Smoking ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Mean Difference ◽  
Smoking During Pregnancy ◽  
Smoking In Pregnancy ◽  
Maternal Smoking During Pregnancy

Abstract: The present study aimed to conduct a systematic review and meta-analysis to evaluate the evidence on the association of maternal smoking during pregnancy with offspring body composition in childhood, adolescence and adulthood. MEDLINE, Web of Science and LILACS databases were searched. Reference lists were also screened. We included original studies, conducted in humans, that assessed the association of maternal smoking during pregnancy with offspring body mass index (BMI) and overweight in childhood, adolescence and adulthood, published through May 1st, 2018. A meta-analysis was used to estimate pooled effect sizes. The systematic review included 64 studies, of which 37 evaluated the association of maternal smoking during pregnancy with overweight, 13 with BMI, and 14 evaluated both outcomes. Of these 64 studies, 95 measures of effect were extracted and included in the meta-analysis. We verified that the quality of evidence across studies regarding maternal smoking in pregnancy and overweight and BMI of offspring to be moderate and low, respectively. Most studies (44 studies) were classified as moderate risk bias. Heterogeneity among studies included was high and, in the random-effects pooled analysis, maternal smoking during pregnancy increased the odds of offspring overweight (OR: 1.43, 95%CI: 1.35; 1.52) and mean difference of BMI (β: 0.31, 95%CI: 0.23; 0.39). In conclusion, offspring of mothers who smoked during pregnancy have higher odds of overweight and mean difference of BMI, and these associations persisted into adulthood.

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