Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight: elucidating bias by pooling data from nine European cohorts
Por:
Strandberg-Larsen K, Poulsen G, Bech BH, Chatzi L, Cordier S, Dale MTG, Fernandez M, Henriksen TB, Jaddoe VW, Kogevinas M, Kruithof CJ, Lindhard MS, Magnus P, Nohr EA, Richiardi L, Rodriguez-Bernal CL, Rouget F, Rusconi F, Vrijheid M and Andersen AN
Publicada:
1 sep 2017
Ahead of Print:
12 oct 2017
Categoría:
Epidemiology
Resumen:
Women who drink light-to-moderately during pregnancy have been observed to have lower risk of unfavourable pregnancy outcomes than abstainers. This has been suggested to be a result of bias. In a pooled sample, including 193 747 live-born singletons from nine European cohorts, we examined the associations between light-to-moderate drinking and preterm birth, birth weight, and small-for-gestational age in term born children (term SGA). To address potential sources of bias, we compared the associations from the total sample with a sub-sample restricted to first-time pregnant women who conceived within six months of trying, and examined whether the associations varied across calendar time. In the total sample, drinking up to around six drinks per week as compared to abstaining was associated with lower risk of preterm birth, whereas no significant associations were found for birth weight or term SGA. Drinking six or more drinks per week was associated with lower birth weight and higher risk of term SGA, but no increased risk of preterm birth. The analyses restricted to women without reproductive experience revealed similar results. Before 2000 approximately half of pregnant women drank alcohol. This decreased to 39% in 2000-2004, and 14% in 2005-2011. Before 2000, every additional drink was associated with reduced mean birth weight, whereas in 2005-2011, the mean birth weight increased with increasing intake. The period-specific associations between low-to-moderate drinking and birth weight, which also were observed for term SGA, are indicative of bias. It is impossible to distinguish if the bias is attributable to unmeasured confounding, which change over time or cohort heterogeneity.
Filiaciones:
Strandberg-Larsen K:
Section for Social Medicine, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, Postbox 2099, 1014, Copenhagen K, Denmark.
Poulsen G:
Section for Social Medicine, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, Postbox 2099, 1014, Copenhagen K, Denmark
Bech BH:
Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
Chatzi L:
Department of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece
Cordier S:
National Institute of Health and Medical Research (INSERM), U1085-IRSET, University of Rennes, Rennes, France
Dale MTG:
Department of Psychology, University of Oslo, Oslo, Norway
Fernandez M:
University of Granada, Granada, Spain
Henriksen TB:
Department of Pediatrics, Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark
Jaddoe VW:
Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
Kogevinas M:
ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
Kruithof CJ:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
Lindhard MS:
Department of Pediatrics, Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark
Magnus P:
Norwegian Institute of Public Health, Oslo, Norway
Nohr EA:
Research Unit for Gynaecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense M, Denmark
Richiardi L:
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
:
Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Tenerife, Spain
Rouget F:
National Institute of Health and Medical Research (INSERM), U1085-IRSET, University of Rennes, Rennes, France
Rusconi F:
Unit of Epidemiology, Meyer Children's University Hospital, Florence, Italy
Vrijheid M:
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Andersen AN:
Section for Social Medicine, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, Postbox 2099, 1014, Copenhagen K, Denmark
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