Abstract
BackgroundEvidence 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.MethodsThe 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.ResultsPresence 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).ConclusionOur 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.
Highlights
Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce
Besides genetic factors the following environmental risk factors have been previously associated with the development of CDH: maternal body mass index (BMI) [8], maternal age [9, 10], pre-gestational diabetes [11], maternal pre-gestational hypertension [12], pre-conceptional diet, especially riboflavin supplementation [13]
We compared data of environmental risk factors obtained from 199 CDH patients born at the University Hospital of Bonn and the University Hospital of Mannheim between 2001 and 2019 to data of environmental risk factors obtained from 597 healthy control newborns born all over Germany in 2011
Summary
Evidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. In a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns. Congenital diaphragmatic hernia (CDH) represents a severe birth-defect with an estimated birth prevalence of 1 in 2500 newborns [1]. It is characterized by a defect in the embryonic development of the diaphragm which results in an incomplete separation of the abdominal cavity and the thoracic cavity. We hypothesized that periconceptional and prenatal environmental factors have a greater impact on the development of CDH than previously assumed [14]. We compared data of environmental risk factors obtained from 199 CDH patients born at the University Hospital of Bonn and the University Hospital of Mannheim between 2001 and 2019 to data of environmental risk factors obtained from 597 healthy control newborns born all over Germany in 2011
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