Prenatal exposures and congenital heart defects in Down syndrome infants

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

“…multiple imputation, regression imputation, or last observation carry forward). Two studies restricted the study population to children with Down's syndrome [29,31], which compromised generalizability. Moreover, these researches were conducted within a wide time span, and socioeconomic heterogeneity across the eras could hardly be handled by statistical models.…”

Maternal caffeine consumption and risk of congenital limb deficiencies

“…Increased maternal plasma cholesterol level may be related to development of congenital vascular disease (Manderson et al, 2002), and increased maternal homocysteine level has been associated with congenital heart defects (Wenstrom et al, 2001) and NTDs (Mills et al, 1995). Although the literature has generally indicated that dietary caffeine is likely to be a weak teratogen at most for humans (Nelson and Forfar, 1971; Fedrick, 1974; Aro et al, 1982; Linn et al, 1982; Rosenberg et al, 1982; Kurppa et al, 1983; Furuhashi et al, 1985; Adams et al, 1989; Tikkanen and Heinonen, 1990; Olsen et al, 1991; Tikkanen and Heinonen, 1991; McDonald et al, 1992; Tikkanen and Heinonen, 1992a; Tikkanen and Heinonen, 1992b; Werler et al, 1992; Ferencz et al, 1993; Tikkanen and Heinonen, 1994; Fixler and Threlkeld, 1998; Samrén et al, 1999; Torfs and Christianson, 1999; Torfs and Christianson, 2000; Browne, 2006; Browne et al, 2007; Miller, 2008; Mongraw–Chaffin et al, 2008; Collier et al, 2009; Schmidt et al, 2009), considering the common use of caffeine by pregnant women, a slight risk elevation could have a significant impact at the population level. Given that LDs are the most frequent malformations induced by caffeine exposure in some animal studies (Fujii et al, 1969; Scott, 1983; Moriguchi and Scott, 1986) and that this relationship between LDs and maternal caffeine consumption has not been examined in humans, the current study explored the association between maternal caffeine consumption and LDs.…”

Can folic acid protect against congenital heart defects in down syndrome?

“…Khoury and Erickson (1992) also found an inverse association, but with maternal age and oral clefts; additionally, they found an association between maternal race and cardiac defects (40% among blacks vs. 17% in whites). With respect to exogenous factors, Fixler and Threlkeld (1998) found no differences in risk of heart defects in relation to maternal illness, medication use, or consumption of caffeinated beverages, cigarettes, or alcohol, but others did find an effect of such maternal exogenous exposures. Khoury and Erickson (1992) found an association between first‐trimester fever and duodenal atresia.…”