Parental alcohol consumption and the risk of congenital heart diseases in offspring: An updated systematic review and meta-analysis

Abstract

Objective The aim of this study was to provide updated evidence to assess the association between parental alcohol consumption and the risk of total congenital heart diseases (CHDs) and specific CHD phenotypes in offspring, and explore the possible dose–response pattern. Methods PubMed, Embase and Chinese databases were searched with an end-date parameter of July 24, 2019 to identify studies meeting pre-stated inclusion criteria. A random-effects model was used to calculate the overall combined risk estimates. A meta-analysis of the dose–response relationship was performed. Subgroup analysis, sensitivity analysis, and Galbraith plot were conducted to explore potential heterogeneity moderators. Results A total of 55 studies involving 41,747 CHD cases and 297,587 controls were identified. Overall, both maternal (odds ratio (OR) = 1.16; 95% confidence interval (CI): 1.05–1.27) and paternal (OR = 1.44; 95% CI: 1.19–1.74) alcohol exposures were significantly associated with risk of total CHDs in offspring. Additionally, a nonlinear dose–response relationship between parental alcohol exposure and risk of total CHDs was observed. With an increase in parental alcohol consumption, the risk of total CHDs in offspring also gradually increases. For specific CHD phenotypes, a statistically significant association was found between maternal alcohol consumption and risk of tetralogy of fallot (OR = 1.20; 95% CI: 1.08–1.33). Relevant heterogeneity moderators have been identified by subgroup analysis, and sensitivity analysis yielded consistent results. Conclusions Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, our review indicates that parental alcohol exposures are significantly associated with the risk of CHDs in offspring, which highlights the necessity of improving health awareness to prevent alcohol exposure during preconception and conception periods.

Patterns of Prenatal Alcohol Exposure and Alcohol‐Related Dysmorphic Features

“…A second motivation for studying the features by timing, quantity, and duration of PAE is that the results, like those from animal models, may elucidate mechanisms whereby exposure affects fetal development. Although the insult leading to some features including heart defects (Zhang et al, 2020) and select craniofacial defects (Godin et al, 2010; Sulik, 2005) is known to occur from first‐trimester PAE, the sensitive periods for many of the other features remain unknown.…”

Proteomic Profiling Reveals Roles of Stress Response, Ca2+ Transient Dysregulation, and Novel Signaling Pathways in Alcohol‐Induced Cardiotoxicity

“…In addition, alcohol exposure during pregnancy is known to disrupt fetal development and increase the risk of fetal alcohol spectrum disorder (FASD; Roozen et al, 2016). Nearly 1 out of 3 FASD children are diagnosed with congenital heart defects, and each year there are approximately 10,000 cases of alcohol‐induced congenital heart defects in the United States, indicating that parental alcohol consumption confers detriment effect on cardiac development in a large number of the children (Zhang et al, 2020). Unfortunately, without effective therapies further heart complications may develop later in life.…”

Parental alcohol exposure and congenital heart diseases in offspring: A causal link with controversial evidence

“…The updated meta-analysis by Zhang et al is the first establishing a positive correlation between parental alcohol consumption and CHD in offspring. 11 This is important considering that although the pathophysiological link has been unanimously proven, all the existing studies until now provided mixed or negative associations. This was a confusing issue for the scientific community.…”

“…Zhang et al., in this issue of the European Journal of Preventive Cardiology , succeeded in providing an updated meta-analysis that eventually confirmed the correlation of prenatal alcohol exposure and CHD. 11 It included 52 studies (three cohort and 49 case–control studies) with a total of 41,290 CHD cases and 296,691 controls. Maternal alcohol consumption was significantly associated with the risk of overall CHD (odds ratio (OR) = 1.12, 95% confidence interval (CI): 1.02–1.22; p = 0.01).…”