Sharon M. Casey, Molly N. Hoffman, Martha M. Werler, Samantha E. Parker
{"title":"Differential Effects of Maternal Exposures on Clubfoot Laterality: A Case–Control Study","authors":"Sharon M. Casey, Molly N. Hoffman, Martha M. Werler, Samantha E. Parker","doi":"10.1002/bdr2.70076","DOIUrl":"10.1002/bdr2.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clubfoot is a common birth defect that affects one or both feet. Evidence suggests increased risks of clubfoot in offspring associated with maternal medication and cigarette smoking exposure in early pregnancy. We explored whether such associations differed by clubfoot laterality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case–control study was conducted in Massachusetts, North Carolina, and New York (2007–2011). State birth defects registries reported clubfoot diagnoses among infants aged < 11 months. Controls without birth defects were random samples of infants from the same catchment areas and born in the same year as cases. Mothers were interviewed within 12 months following delivery. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis included 643 isolated cases (bilateral <i>N</i> = 321, left <i>N</i> = 180, right <i>N</i> = 142) and 2037 controls. Estimates for cigarette smoking in early pregnancy were elevated for bilateral, left-sided, and right-sided cases, with the greatest effect for > 10 cigarettes per day for bilateral clubfoot (OR 2.42, 95% CI 1.37, 4.28). Acetaminophen, antihistamines, and pseudoephedrine were not associated with increased risk across laterality groups (ORs ranged 0.42 to 1.05). Elevated ORs (1.22 to 1.44) were observed for ibuprofen use for each laterality group. Associations for salicylates and ondansetron use, however, were observed for bilateral cases only (OR 1.82, 95% CI 1.07, 3.09; OR 1.64, 95% CI 0.99, 2.73, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The pattern of associations across laterality varied by risk factor, suggesting a complex pathogenesis of clubfoot laterality. Investigations that can incorporate both genetic and environmental risk factors are needed to understand clubfoot etiologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9121,"journal":{"name":"Birth Defects Research","volume":"118 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qun Miao, Sandra I. Dunn, Shi Wu Wen, Jane Lougheed, Rebecca Griffiths, Carolina Lavin Venegas, Maria P. Velez, Mark Walker
{"title":"Maternal Immigrant Status and Mortality in Children With Congenital Heart Disease: A Population-Based Cohort Study","authors":"Qun Miao, Sandra I. Dunn, Shi Wu Wen, Jane Lougheed, Rebecca Griffiths, Carolina Lavin Venegas, Maria P. Velez, Mark Walker","doi":"10.1002/bdr2.70056","DOIUrl":"10.1002/bdr2.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examined the association between maternal immigrant status and survival of children with congenital heart diseases (CHD) in Ontario, Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective population-based cohort study of hospital live births between April 2002 to September 2020 in Ontario, Canada was conducted at the Institute for Clinical Evaluative Sciences. Multilevel Cox hazard regression models generated hazard ratios (HR) for the association between maternal immigrant status and child death while accounting for hospitals as a cluster factor and adjusting for maternal age at birth, neighborhood income and education quintiles, comorbidities, a composite of severe maternal morbidity, gestational age at birth, birth weight, infant sex and residential rurality among all CHD, severe CHD or single ventricle patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among children with any CHD, relative to children born to nonimmigrants, the adjusted HR was 1.17 (95% CI: 1.06–1.30) in children born to nonrefugee immigrants, and 1.33 (95% CI: 1.07–1.65) in those born to refugees. Similar patterns were observed in children with severe CHD, particularly within the single ventricle CHD subcohort, where the adjusted HR for children born to refugees was 2.01 (95% CI: 1.5–2.7) relative to those born to nonimmigrants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Health policy decision-makers should prioritize understanding the underlying causes of mortality in these populations to reduce health inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9121,"journal":{"name":"Birth Defects Research","volume":"118 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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