Congenital Limb Reduction Defects in Infants: A Look at Possible Associations with Maternal Smoking and Hypertension
WASHINGTON UNIV SEATTLE DEPT OF EPIDEMIOLOGY AND INTERNATIONAL HEALTH
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Case control studies suggest an association between prenatal smoking and infant limb defects possibly due to vascular disruption in the embryo. It has also been suggested that maternal hypertension may be associated with the occurrence of congenital limb defects, either due to the effects of the disease or possibly medications such as the calcium channel blockers used to treat this condition. This project examined these associations. Between 1987 and 1995, 1544 singleton infants with limb defects and reduction defects were identified. These cases were frequency matched by year of birth to 6176 children without congenital limb defects. Prenatal smoking was found not to be associated with an increased risk of limb defects in general, nor were the presence of either gestational hypertension or chronic hypertension, as indicated on the birth certificate, associated with increased risk of giving birth to children with limb defects. However, examination of specific types of malformation revealed that maternal smoking was associated with a greater than two-fold increased risk of transverse reduction limb defects. Chronic or gestational hypertension were not associated with increased risks of any specific defect. This finding related to smoking is consistent with previous studies, and emphasizes the continued need for public health interventions designed to reduce prenatal smoking. Studies including a larger number of hypertensive women, preferably including data on the use of specific anti-hypertensive medications prenatally, are needed before any conclusions can be drawn between possible associations of maternal hypertension or its treatment and the occurrence of congenital limb defects.
- Medicine and Medical Research