Risk factors for isolated biliary atresia, National Birth Defects Prevention Study, 1997-2002
Natalie S The1, Margaret A Honein, Alissa R Caton
1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Insights
Biliary atresia risk is higher in infants of non-Hispanic black mothers and those conceived in spring. Low nutrient intake may also play a role in this rare liver disease.
Area of Science:
- Pediatric Hepatology
- Birth Defect Research
- Epidemiology
Background:
- Biliary atresia is a rare congenital liver disease affecting 1 in 12,000 to 19,500 live births.
- Identifying risk factors is crucial for understanding and potentially preventing this condition.
Purpose of the Study:
- To investigate potential risk factors for isolated biliary atresia.
- To examine associations with demographic factors, seasonality, and maternal exposures.
Main Methods:
- Utilized data from the National Birth Defects Prevention Study (1997-2002).
- Conducted a multistate case-control study analyzing clinical information from medical records.
- Assessed risk factors including maternal demographics, lifestyle, and nutritional intake.
Main Results:
- Infants of non-Hispanic black mothers had a higher likelihood of biliary atresia (aOR=2.29).
- Conception during spring was associated with increased risk compared to winter (aOR=2.33).
- Low intake of Vitamin E, copper, phosphorus, and beta-tocopherol showed borderline significance.
Conclusions:
- Seasonal variation and maternal race/ethnicity are potential risk factors for biliary atresia.
- The role of specific nutrient deficiencies requires further investigation.
- Additional research into genetic, infectious, and nutritional exposures is warranted.
Abstract:
Biliary atresia is a rare birth defect that affects 1 in 12,000 to 1 in 19,500 live births. We used data from the National Birth Defects Prevention Study, a multistate case-control study, to identify potential risk factors for isolated biliary atresia (no additional unrelated major birth defects diagnosed). Infants were identified from eight states from 1997 to 2002, with clinical information abstracted from medical records. Potential risk factors assessed include: demographic factors, seasonality, preterm birth, maternal smoking, maternal alcohol use, maternal illicit drug use, maternal health, maternal medication use, maternal vitamin use, and maternal nutrition. Infants of non-Hispanic black mothers were more likely to have biliary atresia than infants of non-Hispanic white mothers (adjusted odds ratio (aOR) = 2.29, 95% confidence interval (CI) 1.07-4.93) and infants conceived during the spring season were more likely to have biliary atresia than infants conceived in winter (aOR = 2.33, 95%CI 1.05-5.16). Low intakes of vitamin E, copper, phosphorus, and beta tocopherol were associated with the occurrence of isolated biliary atresia (borderline significance). Low iron intake had a borderline inverse association with biliary atresia. While this analysis provides support for previous reports of a possible association between seasonal variation and the occurrence of biliary atresia, more data are needed to evaluate whether the seasonal variation is related to infectious agents. The role of nutrients in the development of biliary atresia remains unclear. Further studies of genetic, infectious, and nutrient exposures and the association of biliary atresia are warranted.
