{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:22:19Z","timestamp":1787016139588,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,7,31]],"date-time":"2013-07-31T00:00:00Z","timestamp":1375228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2013,11]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Congenital limb deficiencies (\n LD<\/jats:styled-content>\n )s are characterised by the failure or disruption in formation of limbs or digits. Epidemiological research on maternal exposure to cigarette smoke and\n LDs<\/jats:styled-content>\n is inconclusive.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Data from the\n N<\/jats:styled-content>\n ational\n B<\/jats:styled-content>\n irth\n D<\/jats:styled-content>\n efects\n P<\/jats:styled-content>\n revention\n S<\/jats:styled-content>\n tudy were used to examine\n LDs<\/jats:styled-content>\n and maternal exposure to active or passive cigarette smoke. Mothers of\n LD<\/jats:styled-content>\n case (\n n<\/jats:italic>\n \u2009=\u2009906) and unaffected control (\n n<\/jats:italic>\n \u2009=\u20098352) pregnancies from\n O<\/jats:styled-content>\n ctober 1997 through\n D<\/jats:styled-content>\n ecember 2007 reported on exposure type and quantity. Logistic regression was used to estimate adjusted odds ratio (\n OR<\/jats:styled-content>\n ) and 95% confidence interval [95%\n CI<\/jats:styled-content>\n ]; interactions with folic acid (\n FA<\/jats:styled-content>\n ) intake were tested.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n For any\n LD<\/jats:styled-content>\n ,\n OR<\/jats:styled-content>\n s were elevated for active (1.24 [95%\n CI<\/jats:styled-content>\n 1.01, 1.53]), passive (home) (1.28 [95%\n CI<\/jats:styled-content>\n 1.03, 1.59]), and \u2018active and passive\u2019 (1.34 [95%\n CI<\/jats:styled-content>\n 1.05, 1.70]) exposures. The\n OR<\/jats:styled-content>\n s for longitudinal\n LDs<\/jats:styled-content>\n were elevated for passive (home) (1.62 [95%\n CI<\/jats:styled-content>\n 1.14, 2.31]) and \u2018active and passive\u2019 (1.62 [95%\n CI<\/jats:styled-content>\n 1.09, 2.41]) exposures. The\n OR<\/jats:styled-content>\n for pre\u2010axial\n LDs<\/jats:styled-content>\n were elevated for any (1.39 [95%\n CI<\/jats:styled-content>\n 1.01, 1.90]), active (1.53 [95%\n CI<\/jats:styled-content>\n 1.03, 2.29]), passive (home) (1.82 [95%\n CI<\/jats:styled-content>\n 1.23, 2.69]), and \u2018active and passive\u2019 (1.87 [95%\n CI<\/jats:styled-content>\n 1.20, 2.92]) exposures. For lower limbs,\n ORs<\/jats:styled-content>\n were elevated for passive (home) (1.44 [95%\n CI<\/jats:styled-content>\n 1.01, 2.04]) and smoking 15 or more cigarettes\/day (2.25 [95%\n CI<\/jats:styled-content>\n 1.27, 3.97]). Interactions showed that\n ORs<\/jats:styled-content>\n for any passive smoke exposure were 0.43 and 0.59 higher in the absence of\n FA<\/jats:styled-content>\n intake for any and terminal transverse\n LDs<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Maternal active smoking and exposure to passive cigarette smoke emerged as a potential teratogen that affects limb and digit formation.\n FA<\/jats:styled-content>\n was not found to mitigate the impact.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ppe.12075","type":"journal-article","created":{"date-parts":[[2013,7,31]],"date-time":"2013-07-31T05:45:30Z","timestamp":1375249530000},"page":"509-520","source":"Crossref","is-referenced-by-count":19,"title":["Maternal Periconceptional Exposure to Cigarette Smoking and Congenital Limb Deficiencies"],"prefix":"10.1111","volume":"27","author":[{"given":"Kristin M.","family":"Caspers","sequence":"first","affiliation":[{"name":"Department of Epidemiology College of Public Health The University of Iowa Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Romitti","sequence":"additional","affiliation":[{"name":"Department of Epidemiology College of Public Health The University of Iowa Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Health, New York State Albany NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard S.","family":"Olney","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis B.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Genetics and Teratology Unit Massachusetts General Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha 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