TY - JOUR
T1 - Sociodemographic, health behavioral, and clinical risk factors for anotia/microtia in a population-based case-control study
AU - National Birth Defects Prevention Study
AU - Ryan, Marisa A.
AU - Olshan, Andrew F.
AU - Canfield, Mark A.
AU - Hoyt, Adrienne T.
AU - Scheuerle, Angela E.
AU - Carmichael, Suzan L.
AU - Shaw, Gary M.
AU - Werler, Martha M.
AU - Fisher, Sarah C.
AU - Desrosiers, Tania A.
N1 - Funding Information:
This study was supported by cooperative agreements with the Centers for Disease Control and Prevention and the North Carolina Center for Birth Defects Research and Prevention at the University of North Carolina, Chapel Hill (5U01DD000488, 5U01DD001036). This project was also supported in part by a National Institute on Deafness and other Communication Disorders training grant (T32 DC013018-03). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Center for Disease Control and Prevention, the National Institute on Deafness and other Communication Disorders, or the California Department of Public Health. We thank the California Department of Public Health, Maternal Child and Adolescent Health Division for providing surveillance data from California for this study. We thank the participating families, scientists, and staff from all of the NBDPS sites. We thank Nina Forestieri for replicating the statistical analyses presented herein.
Funding Information:
This study was supported by cooperative agreements with the Centers for Disease Control and Prevention and the North Carolina Center for Birth Defects Research and Prevention at the University of North Carolina, Chapel Hill ( 5U01DD000488 , 5U01DD001036 ). This project was also supported in part by a National Institute on Deafness and other Communication Disorders training grant ( T32 DC013018-03 ). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Center for Disease Control and Prevention, the National Institute on Deafness and other Communication Disorders , or the California Department of Public Health.
Funding Information:
The National Birth Defects Prevention Study (NBDPS) was a case-control study of over 30 types of major structural birth defects. Ten Centers for Birth Defects Research and Prevention (henceforth, “centers”) participated in the NBDPS, which was sponsored by the Centers for Disease Control and Prevention (CDC). Details of the NBDPS design are published [ 33 ]. Briefly, cases with an eligible birth defect were identified through population-based birth defects surveillance registries with active case ascertainment approaches in Arkansas, California, Iowa, Massachusetts, New Jersey, New York, Texas, Georgia, North Carolina, and Utah. Cases were ascertained among live-born infants, stillborn fetuses (≥20 weeks), and elective terminations. Infants without any major birth defect were selected as controls through random sampling of birth certificates or birth hospital records at each center from the same time- and geographic-frame as cases [ 34 ]. All cases and controls had an estimated delivery date (“due date”) between November 1997 and December 2011. Pregnancies with donor gamete(s) or embryos (3 cases and 32 controls) were excluded from our study sample.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/7
Y1 - 2019/7
N2 - Objective: Anotia and microtia are congenital malformations of the external ear with few known risk factors. We conducted a comprehensive assessment of a wide range of potential risk factors using data from the National Birth Defects Prevention Study (NBDPS), a population-based case-control study of non-chromosomal structural birth defects in the United States. Methods: Mothers of 699 infants with anotia or microtia (cases) and 11,797 non-malformed infants (controls) delivered between 1997 and 2011 were interviewed to obtain information about sociodemographic, health behavioral, and clinical characteristics. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated with logistic regression. Results: Infants with anotia/microtia were more likely to be male (aOR, 1.29; 95% CI, 1.10–1.50) and from a multifetal pregnancy (aOR, 1.68; 95% CI, 1.16–2.42). Cases were also more likely to have parents of Hispanic ethnicity (maternal aOR, 3.19; 95% CI, 2.61–3.91; paternal aOR, 2.11; 95% CI, 1.54–2.88), and parents born outside the United States (maternal aOR, 1.29; 95% CI, 1.06–1.57; paternal aOR, 1.92; 95% CI, 1.53–2.41). Maternal health conditions associated with increased odds of anotia/microtia included obesity (aOR, 1.31; 95% CI, 1.06–1.61) and pre-pregnancy diabetes (type I aOR, 9.89; 95% CI, 5.46–17.92; type II aOR, 4.70; 95% CI, 2.56–8.63). Reduced odds were observed for black mothers (aOR, 0.57; 95% CI, 0.38–0.85) and mothers reporting daily intake of folic acid-containing supplements (aOR, 0.59; 95% CI, 0.46–0.76). Conclusion: We identified several risk factors for anotia/microtia, some which have been previously reported (e.g., diabetes) and others which we investigate for perhaps the first time (e.g., binge drinking) that warrant further investigation. Our findings point to some potentially modifiable risk factors and provide further leads toward understanding the etiology of anotia/microtia.
AB - Objective: Anotia and microtia are congenital malformations of the external ear with few known risk factors. We conducted a comprehensive assessment of a wide range of potential risk factors using data from the National Birth Defects Prevention Study (NBDPS), a population-based case-control study of non-chromosomal structural birth defects in the United States. Methods: Mothers of 699 infants with anotia or microtia (cases) and 11,797 non-malformed infants (controls) delivered between 1997 and 2011 were interviewed to obtain information about sociodemographic, health behavioral, and clinical characteristics. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated with logistic regression. Results: Infants with anotia/microtia were more likely to be male (aOR, 1.29; 95% CI, 1.10–1.50) and from a multifetal pregnancy (aOR, 1.68; 95% CI, 1.16–2.42). Cases were also more likely to have parents of Hispanic ethnicity (maternal aOR, 3.19; 95% CI, 2.61–3.91; paternal aOR, 2.11; 95% CI, 1.54–2.88), and parents born outside the United States (maternal aOR, 1.29; 95% CI, 1.06–1.57; paternal aOR, 1.92; 95% CI, 1.53–2.41). Maternal health conditions associated with increased odds of anotia/microtia included obesity (aOR, 1.31; 95% CI, 1.06–1.61) and pre-pregnancy diabetes (type I aOR, 9.89; 95% CI, 5.46–17.92; type II aOR, 4.70; 95% CI, 2.56–8.63). Reduced odds were observed for black mothers (aOR, 0.57; 95% CI, 0.38–0.85) and mothers reporting daily intake of folic acid-containing supplements (aOR, 0.59; 95% CI, 0.46–0.76). Conclusion: We identified several risk factors for anotia/microtia, some which have been previously reported (e.g., diabetes) and others which we investigate for perhaps the first time (e.g., binge drinking) that warrant further investigation. Our findings point to some potentially modifiable risk factors and provide further leads toward understanding the etiology of anotia/microtia.
KW - Anotia
KW - Birth defect
KW - Congenital malformation
KW - Ear
KW - Microtia
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U2 - 10.1016/j.ijporl.2019.03.026
DO - 10.1016/j.ijporl.2019.03.026
M3 - Article
C2 - 30928866
AN - SCOPUS:85063546497
SN - 0165-5876
VL - 122
SP - 18
EP - 26
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
ER -