Case-control study of the association between Lifestyle and environmental factors, and anorectal malformations

2022 Fiscal Year Final Research Report

• Project/Area Number: 20H03946
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Toho University
• Principal Investigator: Nishiwaki Yuji 東邦大学, 医学部, 教授 (40237764)
• Co-Investigator(Kenkyū-buntansha): 黒田 達夫 慶應義塾大学, 医学部(信濃町), 教授 (60170130) ; 道川 武紘 東邦大学, 医学部, 講師 (80594853)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 先天異常 / 鎖肛 / 生活環境因子 / 一次予防 / 症例対照研究

Outline of Final Research Achievements

This study aimed to evaluate the association between lifestyle and environmental factors and anorectal malformations in a case-control study design. Logistic regression analysis was performed on 72 case pairs (mother and baby) and 1,517 control pairs to determine the association between lifestyle factors (body mass index, smoking, and alcohol consumption) and anorectal malformations. Mother's prepregnancy overweight (obesity) was not associated with rectoanal malformations. Mother's smoking, on the other hand, showed an increased odds ratio with point estimates exceeding 1. The father's smoking (answered by the mother) also suggested an association with anorectal malformation, and the odds ratio was not significantly attenuated after adjusting for the mother's smoking. No association was observed for diabetes or gestational diabetes.

Free Research Field

衛生学　環境保健学

Academic Significance and Societal Importance of the Research Achievements

直腸肛門奇形（鎖肛）は数千人に1人の頻度で発生する先天異常で生命予後はよいものであるが、家族の心理的経済的負担、児のその後の生活の質への影響が課題であり、予防医学の進展にも期待が寄せられている。国際的には介入可能な外的環境要因を探索する疫学研究が進みつつあるが、日本で鎖肛発生と関連する因子を調べた質の高い疫学研究はほとんどなかった。本研究は、日本の集団で鎖肛の一次予防の可能性を検討したことに大きな意義があるとともに、この経験を元に他の先天異常にも拡大して予防因子の検討を行うことで先天異常の予防に向けた公衆衛生的取り組みにつなげられる可能性がある。