Association of Alcohol Use Diagnostic Codes in Pregnancy and Offspring Conotruncal and Endocardial Cushion Heart Defects

Author:

Harvey Drayton C.1ORCID,Baer Rebecca J.234ORCID,Bandoli Gretchen2,Chambers Christina D.2,Jelliffe‐Pawlowski Laura L.35,Kumar S. Ram167ORCID

Affiliation:

1. Department of Surgery Keck School of Medicine of University of Southern California Los Angeles CA

2. Department of Pediatrics and Herbert Wertheim School of Public Health and Longevity Science University of California San Diego La Jolla CA

3. The California Preterm Birth Initiative University of California San Francisco San Francisco CA

4. Department of Obstetrics, Gynecology and Reproductive Sciences University of California San Francisco San Francisco CA

5. Department of Epidemiology and Biostatistics University of California San Francisco San Francisco CA

6. Department of Pediatrics Keck School of Medicine of University of Southern California Los Angeles CA

7. Heart Institute, Children’s Hospital Los Angeles Los Angeles CA

Abstract

Background The pathogenesis of congenital heart disease (CHD) remains largely unknown, with only a small percentage explained solely by genetic causes. Modifiable environmental risk factors, such as alcohol, are suggested to play an important role in CHD pathogenesis. We sought to evaluate the association between prenatal alcohol exposure and CHD to gain insight into which components of cardiac development may be most vulnerable to the teratogenic effects of alcohol. Methods and Results This was a retrospective analysis of hospital discharge records from the California Office of Statewide Health Planning and Development and linked birth certificate records restricted to singleton, live‐born infants from 2005 to 2017. Of the 5 820 961 births included, 16 953 had an alcohol‐related International Classification of Diseases , Ninth and Tenth Revisions (ICD‐9; ICD‐10 ) code during pregnancy. Log linear regression was used to calculate risk ratios (RR) for CHD among individuals with an alcohol‐related ICD ‐9 and ICD10 code during pregnancy versus those without. Three models were created: (1) unadjusted, (2) adjusted for maternal demographic factors, and (3) adjusted for maternal demographic factors and comorbidities. Maternal alcohol‐related code was associated with an increased risk for CHD in all models (RR, 1.33 to 1.84); conotruncal (RR, 1.62 to 2.11) and endocardial cushion (RR, 2.71 to 3.59) defects were individually associated with elevated risk in all models. Conclusions Alcohol‐related diagnostic codes in pregnancy were associated with an increased risk of an offspring with a CHD, with a particular risk for endocardial cushion and conotruncal defects. The mechanistic basis for this phenotypic enrichment requires further investigation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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