Felicitas Schulz1,2, Ekkehart Jenetzky3,4, Nadine Zwink3, Charlotte Bendixen5, Florian Kipfmueller6, Neysan Rafat7, Andreas Heydweiller8, Lucas Wessel9, Heiko Reutter6,10, Andreas Mueller6, Thomas Schaible7. 1. Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany. felicitas.schulz@uni-bonn.de. 2. Department of Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany. felicitas.schulz@uni-bonn.de. 3. Department of Child and Adolescent Psychiatry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 4. Faculty of Health, School of Medicine, University of Witten/Herdecke, Witten, Germany. 5. Department of Surgery, University Hospital Bonn, Bonn, Germany. 6. Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany. 7. Department of Neonatology, University Children's Hospital Mannheim, University of Heidelberg, Mannheim, Germany. 8. Department of Pediatric Surgery, University Hospital Bonn, Bonn, Germany. 9. Department of Pediatric Surgery, University Hospital Mannheim, Mannheim, Germany. 10. Institute of Human Genetics, University Hospital Bonn, Bonn, Germany.
Abstract
BACKGROUND: Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. Here, in a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns. METHODS: The following data was collected: time of conception and birth, maternal BMI, parental risk factors such as smoking, alcohol or drug intake, use of hairspray, contact to animals and parental chronic diseases. CDH patients were born between 2001 and 2019, all healthy control newborns were born in 2011. Patients and control newborns were matched in the ratio of three to one. RESULTS: Presence of CDH was significantly associated with maternal periconceptional alcohol intake (odds ratio = 1.639, 95% confidence interval 1.101-2.440, p = 0.015) and maternal periconceptional use of hairspray (odds ratio = 2.072, 95% confidence interval 1.330-3.229, p = 0.001). CONCLUSION: Our study suggests an association between CDH and periconceptional maternal alcohol intake and periconceptional maternal use of hairspray. Besides the identification of novel and confirmation of previously described parental risk factors, our study underlines the multifactorial background of isolated CDH.
BACKGROUND: Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. Here, in a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns. METHODS: The following data was collected: time of conception and birth, maternal BMI, parental risk factors such as smoking, alcohol or drug intake, use of hairspray, contact to animals and parental chronic diseases. CDH patients were born between 2001 and 2019, all healthy control newborns were born in 2011. Patients and control newborns were matched in the ratio of three to one. RESULTS: Presence of CDH was significantly associated with maternal periconceptional alcohol intake (odds ratio = 1.639, 95% confidence interval 1.101-2.440, p = 0.015) and maternal periconceptional use of hairspray (odds ratio = 2.072, 95% confidence interval 1.330-3.229, p = 0.001). CONCLUSION: Our study suggests an association between CDH and periconceptional maternal alcohol intake and periconceptional maternal use of hairspray. Besides the identification of novel and confirmation of previously described parental risk factors, our study underlines the multifactorial background of isolated CDH.
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