Details:

Alternative Title:
Birth Defects Res A Clin Mol Teratol
Personal Author:
Van Bennekom, Carla M. ; Mitchell, Allen A. ; Moore, Cynthia A. ; Werler, Martha M.
Van Bennekom, Carla M. ; Mitchell, Allen A. ; Moore, Cynthia A. ; Werler, Martha M. Less -
Description:
Background

Little is known about the etiology of nonsyndromic microtia. This study investigated the hypothesis that microtia is caused by vascular disruption.

Methods

The study analyzed data from the population-based National Birth Defects Prevention Study (NBDPS) for deliveries between 1997 and 2005. Four hundred eleven nonsyndromic cases of microtia, with or without additional defects, were compared to 6560 nonmalformed infants with respect to maternal exposures to vasoactive medications and smoking during the periconceptional period and conditions that have previously been associated with vascular events (multiple gestation, maternal history of type 1, type 2, or gestational diabetes, and hypertension). Odds ratios (ORs) were estimated with multivariable models, controlling for the effects of race/ethnicity, education, periconceptional folic acid use, and study center.

Results

Risk estimates for vasoactive medications and smoking were not meaningfully increased. Maternal type 1/2 diabetes was diagnosed before or during the index pregnancy in 4% and 1% of cases, respectively, compared to 1% and 0.05% of controls; the adjusted OR for these two groups combined was 7.2 (95% confidence interval [CI], 3.9–13.1). Gestational diabetes was observed for 9% of cases and 6% of controls; the OR was moderately elevated (OR, 1.4; 95% CI, 0.9–2.0). ORs were also increased for multiple gestations (OR, 2.5; 95% CI, 1.5–4.2) and pre-existing hypertension (OR, 1.6; 95% CI, 1.0–2.5).

Conclusions

Because ORs were only elevated for diabetes and not for vasoactive exposures or other potential vascular events, findings suggest that some microtia occurrences may be part of the diabetic embryopathy rather than manifestations of vascular disruption.


Subject:
[+]
Cardiovascular Agents
Congenital Abnormalities
Congenital Microtia
Diabetes, Gestational
Diabetes Complications
Diabetes Mellitus
Ear
Female
Humans
Infant, Newborn
Maternal Exposure
Odds Ratio
Pregnancy
Pregnancy In Diabetics
Risk Assessment
Risk Factors
Smoking

Source:
Birth Defects Res A Clin Mol Teratol. 97(1):53-59
Pubmed ID:
23180593
Pubmed Central ID:
PMC4521508
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States ; U01 DD000493/DD/NCBDD CDC HHS/United States ; U01DD000493/DD/NCBDD CDC HHS/United States
CC999999/Intramural CDC HHS/United States ; U01 DD000493/DD/NCBDD CDC HHS/United States ; U01DD000493/DD/NCBDD CDC HHS/United States Less -
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:bbe6ead72ad510a3dc194dc701b238cbd495754a8306d92c29398cf194c2514f
File Type:

Supporting Files

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