Periconceptional nutrient intakes and risks of conotruncal heart defects

Abstract

Evidence exists for an association between maternal use of a vitamin supplement with folic acid in early pregnancy and a reduced risk for offspring with conotruncal heart defects. Few inquiries about periconceptional nutrition, other than folate, and risk of heart defects have been made. Data derived from a population-based case-control study of fetuses and liveborn infants among a cohort of California births between July 1999 and June 2004. In total, 76% of eligible case mothers and 77% of eligible control mothers were interviewed. Cases included 140 with d-transposition of great arteries (dTGA), and 163 with tetralogy of Fallot (TOF). Total number of controls was 698. Self-reported use of vitamins was elicited by questionnaire for the periconceptional period, Dietary nutrient intake was elicited by a well-known food frequency questionnaire. The odds ratio for dTGA associated with supplemental vitamin use was 1.0 (95% confidence interval, 0.7-1.5) and for TOF was 0.9 (0.6-1.3). We observed increased risks associated with lower dietary intakes of linoleic acid, total carbohydrate, and fructose for dTGA, whereas decreased risks were observed for lower intakes of total protein and methionine for TOF. Lower dietary intake of several micronutrients, namely folate, niacin, riboflavin, and vitamins B12, A, and E, even after simultaneous adjustment for other studied nutrients, were associated with increased risks of dTGA, but not for TOF. These associations were observed among women who did not use vitamin supplements periconceptionally. Analytic consideration of several potential confounders did not reveal alternative interpretations of the results. Our population-based case-control study attempted to extend the knowledge base on nutrition and heart defect risk and prevention.

Haploinsufficiency of insulin gene enhancer protein 1 (ISL1) is associated with d‐transposition of the great arteries

“…We used data derived from a population-based case–control study, California Study of Birth Defects Causes, as described elsewhere (Lammer et al 2009; Shaw et al 2010). Briefly, the study population was defined by pregnant women who lived in Los Angeles, San Francisco, or Santa Clara counties, and who delivered between July 1999 and June 2004.…”

Folate, Homocysteine and the Cardiac Neural Crest

“…and ). Thus, it is important to note that, although folate is the principle nutrient considered in this review, and although there are more data in support of folate supplementation as a way to maintain normal homocysteine concentrations and also reduce congenital defects, in fact there are nutrients other than folate, e.g., vitamin B‐6 (Hobbs et al, ) and vitamin B‐12 (Finnell et al, ; Verkleij‐Hagoort et al, ; Brouns et al, ; Shaw et al, ), which also deserve and receive attention, as their maternal deficiency also may increase both homocysteine and the risk for congenital defects.…”

What We Can Learn From Twins

“…9 Nutrient and micronutrient intake during pregnancy has been linked to fetal congenital heart defects. 10 This may impact not only fetal growth, but potentially organogenesis as well. It is possible that such nutritional deficiency would make the fetus more susceptible to other teratogenic factors such as prenatal exposures or poor maternal health.…”