Association between Maternal Alcohol USE in Early Pregnancy and Congenital Heart Defects

This study will employ a case-control design to examine the odds of congenital heart defects among infants born to women who report alcohol consumption, frequent drinking and binge drinking in the three months prior to pregnancy. Alcohol use and other risk factors prior to pregnancy will be obtained from the Pregnancy Risk Assessment Monitoring Surveillance (PRAMS), an ongoing national study administered in selected participating states. Birth defects data will be derived from linked birth certificates from 10 participating states over a ten year period (1996-2005). The PRAMS data are representative of births occurring annually in each state and contain responses from post-partum mothers that can be linked with birth certificate data.

For this assessment, cases will include infants born with a congenital cardiac defect as indicated on the birth certificate. There will be two control groups. One control group will consist of infants with no indication of a congenital abnormality on their birth certificate. A second control group will include infants born with Down's syndrome indicated on their birth certificate in order to investigate potential reporting and recall biases. Unadjusted odds ratios for alcohol use, frequent drinking, binge drinking, demographic, behavioral, and health related variables will be computed. Significant factors will be entered into a multinomial logistic regression analysis for model fitting and calculation of adjusted odds ratios predicting the role of pre-pregnancy alcohol use on congenital cardiac defects.

Alcohol-use is an identifiable and preventable risk factor among women seeking to become pregnant. Maternal alcohol-use during pregnancy may be related to congenital cardiac defects, one of the leading types of birth defects. This study seeks to assess the strength of this relationship.