University:
Boston University
Course:
SAR HP 151 | Introduction to Health Professions
Academic year:

2023
Views:

244

Pages:

22
Author:

vielay3og

Anotia/Microtia Study Race/ethnicity Cases n=155 Controls n=854 White, non-Hisp. Hispanic African-Amer. Asian-Amer. Native Amer. 45.2% 41.3% 5.2% 7.5% 1.9% 65.2% 18.5% 11.7% 3.6% 0.9% Anotia/Microtia Study Sex: Sex ratio: 1.9 65% male vs. 52% male controls Associated malformations: 75% with HFM 35% with defect other than HFM Hemifacial Microsomia Study • Mothers were interviewed by telephone • Questions on – Demographic factors – Reproductive factors – Behaviors – Illnesses, medications, vitamins Anotia/Microtia Study Diabetes: pre-existing or gestational (lunar months 1 -5) Body mass index: prepregnancy height/meters2 Vitamin supplementation: Folic acidcontaining vitamin 1st use in lunar month 1 1st use in lunar months 2 or 3 Anotia/Microtia Study Diabetes Overall pre-preg. dx LM1-3 dx LM 4-5 Cases n=155 Controls n=854 16 (10.3%) 8 (5.2%) 3 (1.9%) 5 (3.2%) 12 (1.4%) 4 (0.5%) 2 (0.2%) 6 (0.7%) Anotia/Microtia Study Body mass index (kg/m2) <19 19-23.9 24-27.9 28-31.9 >32 Unknown Cases n=155 Controls n=854 19 (12.3%) 64 (41.3%) 27 (17.4%) 21 (13.5%) 13 (8.4%) 11 (7.1%) 54 (6.3%) 446 (52.2%) 175 (20.5%) 87 (10.2%) 72 (8.4%) 20 (2.3%) Anotia/Microtia Study F.A. 1st use in LM 1 LM 2 or 3 Later or none Cases n=155 44 (28.4%) 70 (45.2%) 41 (26.5%) Controls n=854 275 (32.2%) 454 (53.2%) 125 (14.6%) Anotia/Microtia Study Risk factor Odds ratio@ 95% CI Diabetes BMI: <19* BMI: >28* F.A. LM 1-3 6.3 2.3 1.2 0.7 2.7-14.9 1.2-4.3 0.7-2.1 0.4-1.1 @Adjusted for maternal age, education, income, race, and # gestations. *ref. category 19-23.9 Does vitamin use modify the effect of diabetes on anotia/microtia risk? Does vitamin use modify the effect of diabetes on anotia/microtia risk? Diabetes and vitamins? Birth defects Hydrocephaly Heart defects Respiratory tract Pyloric stenosis *p<.05 No Yes 3.9* 0.15 2.5 0 4.5* 1.0 6.8 0 4.0 0 Anotia/Microtia Study Diabetes Cases Controls + F.A. use OR (95% CI)* 11 (7.1%) 10 (1.2%) 5.5 (2.0-15.0) - F.A. use OR (95% CI)* 5 (12.8%) 2 (1.7%) 9.8 (1.1-87.0) *Adjusted for maternal age, education, income, race, and # gestations Anotia/Microtia Study Limitations: Study designed to capture HFM cases Bilateral cases not ascertained Ascertainment of anotia/microtia cases is not likely to be complete Anotia/Microtia Study Limitations: Would cases born to women with diabetes high or low BMI vitamin supplementation be more or less likely to be in the study? Anotia/Microtia Study Strengths: Ethnic/race and sex distributions in present study were similar to CBDMP Anotia/Microtia Study Limitations: Retrospective recall Imperfect measure of diabetes Anotia/Microtia Study Conclusions: Our findings confirm those from Italy: diabetes appears to increase anotia/microtia risk Anotia/Microtia Study Conclusions: Our findings suggest that, unlike NTDs, obesity does not increase anotia/microtia risk Rather, our findings suggest women with low pre-pregnant BMI might have an increased risk Anotia/Microtia Study Conclusions: Our findings suggest that folic acidcontaining vitamin supplementation does not attenuate the effects of diabetes on anotia/microtia risk. Anotia/Microtia Sideness: 65% are unilateral 61% are right-sided Anotia/Microtia Study Body mass index (kg/m2) <19 19-23.9 24-27.9 28-31.9 >32 Unknown Cases n=155 (12.3%) (41.3%) (17.4%) (13.5%) (8.4%) (7.1%) Controls n=854 (6.3%) (52.2%) (20.5%) (10.2%) (8.4%) (2.3%)