Maternal occupation and the risk of major birth defects: A follow-up analysis from the National Birth Defects Prevention Study

This study further examined the association between selected maternal occupations and a variety of birth defects identified from prior analysis and explored the effect of work hours and number of jobs held and potential interaction between folic acid and occupation. Data from a population-based, mul...

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Bibliographic Details
Published in:International journal of hygiene and environmental health 2013-06, Vol.216 (3), p.317-323
Main Authors: Lin, Shao, Herdt-Losavio, Michele L., Chapman, Bonnie R., Munsie, Jean-Pierre, Olshan, Andrew F., Druschel, Charlotte M.
Format: Article
Language:English
Subjects:
Adult
Air. Soil. Water. Waste. Feeding
Biological and medical sciences
Birth defects
Case-Control Studies
Congenital Abnormalities - epidemiology
Environment. Living conditions
Female
Folic acid
Folic Acid - therapeutic use
Humans
Medical sciences
Mothers
Occupation
Occupations
Odds Ratio
Prevention and actions
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk
Toxicology
Vitamin B Complex - therapeutic use
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Summary:This study further examined the association between selected maternal occupations and a variety of birth defects identified from prior analysis and explored the effect of work hours and number of jobs held and potential interaction between folic acid and occupation. Data from a population-based, multi-center case–control study was used. Analyses included 45 major defects and specific sub-occupations under five occupational groups: healthcare workers, cleaners, scientists, teachers and personal service workers. Both logistic regression and Bayesian models (to minimize type-1 errors) were used, adjusted for potential confounders. Effect modification by folic acid was also assessed. More than any other occupation, nine different defects were positively associated with maids or janitors [odds ratio (OR) range: 1.72–3.99]. Positive associations were also seen between the following maternal occupations and defects in their children (OR range: 1.35–3.48): chemists/conotruncal heart and neural tube defects (NTDs), engineers/conotruncal defects, preschool teachers/cataracts and cleft lip with/without cleft palate (CL/P), entertainers/athletes/gastroschisis, and nurses/hydrocephalus and left ventricular outflow tract heart defects. Non-preschool teachers had significantly lower odds of oral clefts and gastroschisis in their offspring (OR range: 0.53–0.76). There was a suggestion that maternal folic acid use modified the effects with occupations including lowering the risk of NTDs and CL/P. No consistent patterns were found between maternal work hours or multiple jobs by occupation and the risk of birth defects. Overall, mothers working as maids, janitors, biologists, chemists, engineers, nurses, entertainers, child care workers and preschool teachers had increased risks of several malformations and non-preschool teachers had a lower risk of some defects. Maternal folic acid use reduced the odds of NTDs and CL/P among those with certain occupations. This hypothesis-generating study will provide clues for future studies with better exposure data.
ISSN:1438-4639
1618-131X
DOI:10.1016/j.ijheh.2012.05.006