Evaluation of interactive effects between paternal alcohol consumption and paternal socioeconomic status and environmental exposures on congenital heart defects

Nie, Zhiqiang; Qu, Yanji; Han, Fengzhen; Bell, Erin M.; Zhuang, Jian; Chen, Jimei; Francois, Melissa; Lipton, Emily; Matale, Rosemary; Cui, Weilun; Liang, Qianhong; Lu, Xiangzhang; Huang, Huiwen; Lv, Jun-Feng; Ou, Yanqiu; Mai, Jinzhuang; Wu, Yong; Gao, Xing; Huang, Yating; Lin, Shao; Liu, Xiaoqing

doi:10.1002/bdr2.1759

Cited by 8 publications

(1 citation statement)

References 49 publications

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“…In recent years, substantial epidemiological evidence has demonstrated that non-genetic factors such as social determinants of health and adverse healthy lifestyle also contribute to abnormal cardiovascular development in fetuses, leading to cardiovascular malformation. The dominant factors of CHD could be divided into six main categories, namely (1) sociodemographic factors, including parental age (11,12), household annual income and education level (13); (2) adverse lifestyle (14); (3) maternal diseases, including pre-pregnancy diabetes (15) and fever (16); (4) environmental factors such as secondhand smoke exposure (17) and environmental pollution (18); (5) supplements such as folic acid and multivitamin (19); and (6) mode of conception (20). Previous research mainly focused on the association between limited predictors and the risk of CHD, and some conclusions involving maternal fever (16,21), maternal folic acid, and multivitamin supplementation (19,22,23) have been inconsistent.…”

Section: Introductionmentioning

confidence: 99%

How Parental Predictors Jointly Affect the Risk of Offspring Congenital Heart Disease: A Nationwide Multicenter Study Based on the China Birth Cohort

Zhang

Sun

Zhao

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveCongenital heart disease (CHD) is complex in its etiology. Its genetic causes have been investigated, whereas the non-genetic factor related studies are still limited. We aimed to identify dominant parental predictors and develop a predictive model and nomogram for the risk of offspring CHD.MethodsThis was a retrospective study from November 2017 to December 2021 covering 44,578 participants, of which those from 4 hospitals in eastern China were assigned to the development cohort and those from 5 hospitals in central and western China were used as the external validation cohort. Univariable and multivariable analyses were used to select the dominant predictors of CHD among demographic characteristics, lifestyle behaviors, environmental pollution, maternal disease history, and the current pregnancy information. Multivariable logistic regression analysis was used to construct the model and nomogram using the selected predictors. The predictive model and the nomogram were both validated internally and externally. A web-based nomogram was developed to predict patient-specific probability for CHD.ResultsDominant risk factors for offspring CHD included increased maternal age [odds ratio (OR): 1.14, 95% CI: 1.10–1.19], increased paternal age (1.05, 95% CI: 1.02–1.09), maternal secondhand smoke exposure (2.89, 95% CI: 2.22–3.76), paternal drinking (1.41, 95% CI: 1.08–1.84), maternal pre-pregnancy diabetes (3.39, 95% CI: 1.95–5.87), maternal fever (3.35, 95% CI: 2.49–4.50), assisted reproductive technology (2.89, 95% CI: 2.13–3.94), and environmental pollution (1.61, 95% CI: 1.18–2.20). A higher household annual income (100,000–400,000 CNY: 0.47, 95% CI: 0.34–0.63; > 400,000 CNY: 0.23, 95% CI: 0.15–0.36), higher maternal education level (13–16 years: 0.68, 95% CI: 0.50–0.93; ≥ 17 years: 0.87, 95% CI: 0.55–1.37), maternal folic acid (0.21, 95% CI: 0.16–0.27), and multivitamin supplementation (0.33, 95% CI: 0.26–0.42) were protective factors. The nomogram showed good discrimination in both internal [area under the receiver-operating-characteristic curve (AUC): 0.843] and external validations (development cohort AUC: 0.849, external validation cohort AUC: 0.837). The calibration curves showed good agreement between the nomogram-predicted probability and actual presence of CHD.ConclusionWe revealed dominant parental predictors and presented a web-based nomogram for the risk of offspring CHD, which could be utilized as an effective tool for quantifying the individual risk of CHD and promptly identifying high-risk population.

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Section: Introductionmentioning

confidence: 99%

How Parental Predictors Jointly Affect the Risk of Offspring Congenital Heart Disease: A Nationwide Multicenter Study Based on the China Birth Cohort

Zhang

Sun

Zhao

et al. 2022

Front. Cardiovasc. Med.

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Paternal Preconception Hepatitis B Virus Infection and Risk of Congenital Heart Disease in Offspring

Yang,

Liu,

Han

et al. 2024

JAMA Pediatr

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ImportancePrevious evidence suggests that maternal hepatitis B virus (HBV) infection during prepregnancy or pregnancy is associated with congenital heart diseases (CHDs) in offspring. However, the association of paternal HBV infection with CHDs is not well examined.ObjectiveTo explore the association of paternal preconception HBV infection with CHDs in offspring.Design, Setting, and ParticipantsThis retrospective cohort study used propensity score matching of data from the Chinese National Free Preconception Checkup Project (NFPCP) from January 1, 2010, to December 31, 2018. Male participants whose wives were aged 20 to 49 years, were uninfected with HBV, and successfully conceived within 1 year after prepregnancy examination were enrolled. Data were analyzed from March 2023 to February 2024.ExposuresThe primary exposure was paternal preconception HBV infection status, including uninfected, previous infection (both serum hepatitis B surface antigen and hepatitis B envelope antigen negative), and new infection (serum hepatitis B surface antigen positive). Maternal HBV immune status was further classified as immune or susceptible.Main Outcomes and MeasuresThe main outcome was CHDs, which were collected from the birth defect registration card of the NFPCP. Logistic regression with robust error variances was used to estimate the association between paternal preconception HBV infection and CHDs in offspring.ResultsA total of 6 675 540 couples participated in the NFPCP service. After matching husbands with and without preconception HBV infection in a 1:4 ratio, 3 047 924 couples (median age of husbands, 27 years [IQR, 25-30 years]) were included in this study. Of these couples, 0.025% had offspring with CHDs. Previous paternal HBV infection was independently associated with CHDs in offspring (adjusted relative risk [ARR], 1.40; 95% CI, 1.11-1.76) compared with no infection. Similar results were obtained in subgroup analyses according to maternal HBV immune status. Compared with couples with uninfected husbands and susceptible wives, the risk of CHDs in offspring among couples with previously HBV-infected husbands was similar in couples with wives with susceptible immune status (ARR, 1.49; 95% CI, 1.10-2.03) and in those with wives with immunity (ARR, 1.49; 95%CI, 1.07-2.09). A significantly higher CHD risk in offspring was found among couples with newly infected husbands and immune wives (ARR, 1.38; 95% CI, 1.05-1.82), but there was no difference in risk among those with newly infected husbands and susceptible wives (ARR, 0.99; 95% CI, 0.72-1.36). No interactions were found between maternal immune status and paternal HBV infection.Conclusions and RelevanceIn this cohort study using propensity score matching, previous paternal preconception HBV infection was associated with CHD risk in offspring. The findings suggest that personalized reproductive guidance regarding HBV screening and staying free of HBV infection should be provided for both wives and husbands.

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Parental Smoking and the Risk of Birth Defects in Offspring in China: A Systematic Review and meta‐Analysis

Han,

Zhang,

Liu

et al. 2024

Birth Defects Research

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ObjectiveA meta‐analysis of case‐control studies was conducted to assess the risk of birth defects in offspring in China associated with maternal active and passive smoking and paternal smoking.MethodsFour electronic databases were searched for qualified research up to December 2023. A Random‐effect model or fixed‐effect model was used to calculate the overall comprehensive risk estimates; and the relationship between parental smoking and the risk of birth defects in different periods of pregnancy. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity.ResultsSixty‐two qualified studies involving 137,574 cases and 8,770,837 controls were included. Overall, maternal active smoking (OR = 2.19; 95% confidence interval (CI): 1.72–2.79; p < 0.01) and passive smoking (OR = 2.59,95% CI: 2.24–2.99; p < 0.01) as well as paternal active smoking (OR = 1.47,95% CI: 1.34–1.62; p < 0.01) were significantly associated with birth defect risk. The sources of heterogeneity were explored by subgroup analysis. Subgroup analysis showed that the risk of congenital heart disease in offspring was increased in paternal and maternal active smoking (OR = 2.97, 95% CI: 2.01–4.39; OR = 1.51, 95% CI: 1.30–1.74), respectively. Sensitivity analysis yielded consistent results.ConclusionMaternal active and passive smoking and paternal active smoking are risk factors for birth defects in offspring. Parents should be encouraged to quit smoking during the perinatal period and pregnancy.

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Evaluation of interactive effects between paternal alcohol consumption and paternal socioeconomic status and environmental exposures on congenital heart defects

Cited by 8 publications

References 49 publications

How Parental Predictors Jointly Affect the Risk of Offspring Congenital Heart Disease: A Nationwide Multicenter Study Based on the China Birth Cohort

How Parental Predictors Jointly Affect the Risk of Offspring Congenital Heart Disease: A Nationwide Multicenter Study Based on the China Birth Cohort

Paternal Preconception Hepatitis B Virus Infection and Risk of Congenital Heart Disease in Offspring

Parental Smoking and the Risk of Birth Defects in Offspring in China: A Systematic Review and meta‐Analysis

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