Paternal exposure to Agent Orange and spina bifida: A meta-analysis

Ngo, Anh Duc, Taylor, Richard and Roberts, Christine L. (2010) Paternal exposure to Agent Orange and spina bifida: A meta-analysis. European Journal of Epidemiology, 25 1: 37-44. doi:10.1007/s10654-009-9401-4

Author Ngo, Anh Duc
Taylor, Richard
Roberts, Christine L.
Title Paternal exposure to Agent Orange and spina bifida: A meta-analysis
Journal name European Journal of Epidemiology   Check publisher's open access policy
ISSN 0393-2990
Publication date 2010-01
Sub-type Article (original research)
DOI 10.1007/s10654-009-9401-4
Volume 25
Issue 1
Start page 37
End page 44
Total pages 8
Place of publication Dordrecht, Netherlands
Publisher Springer Netherlands
Collection year 2011
Language eng
Formatted abstract
The objective of this study is to conduct a meta-analysis of published and unpublished studies that examine the association between Agent Orange (AO) exposure and the risk of spina bifida. Relevant studies were identified through a computerized literature search of Medline and Embase from 1966 to 2008; a review of the reference list of retrieved articles and conference proceedings; and by contacting researchers for unpublished studies. Both fixed-effects and random-effects models were used to pool the results of individual studies. The Cochrane Q test and index of heterogeneity (I 2) were used to evaluate heterogeneity, and a funnel plot and Egger's test were used to evaluate publication bias. Seven studies, including two Vietnamese and five non-Vietnamese studies, involving 330 cases and 134,884 non-cases were included in the meta-analysis. The overall relative risk (RR) for spina bifida associated with paternal exposure to AO was 2.02 (95% confidence interval [CI]: 1.48-2.74), with no statistical evidence of heterogeneity across studies. Non-Vietnamese studies showed a slightly higher summary RR (RR = 2.22; 95% CI: 1.38-3.56) than Vietnamese studies (RR = 1.92 95% CI: 1.29-2.86). When analyzed separately, the overall association was statistically significant for the three case-control studies (Summary Odds Ratio = 2.25, 95% CI: 1.31-3.86) and the cross sectional study (RR = 1.97, 95% CI: 1.31-2.96), but not for the three cohort studies (RR: 2.11; 95% CI: 0.78-5.73). Paternal exposure to AO appears to be associated with a statistically increased risk of spina bifida. © 2009 Springer Science+Business Media B.V.
Keyword Agent Orange
Birth defects
Spina bifida
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online: 6 November 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 07 Feb 2010, 00:06:44 EST