Elisabeth Leirgul1,2, Trude Gildestad1, Roy Miodini Nilsen1,3, Tatiana Fomina1, Kristoffer Brodwall1, Gottfried Greve2,4, Stein Emil Vollset1,5, Henrik Holmstrøm6, Grethe S Tell1,5, Nina Øyen1,7. 1. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 2. Department of Clinical Science, University of Bergen, Bergen, Norway. 3. Department of Clinical Research, Haukeland University Hospital, Bergen, Norway. 4. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. 5. Norwegian Institute of Public Health, Bergen, Norway. 6. Department of Pediatrics, Oslo University Hospital, Oslo, Norway. 7. Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway.
Abstract
BACKGROUND: The birth prevalence of congenital heart defects (CHDs) has decreased in Canada and Europe. Recommended intake of folic acid in pregnancy is a suggestive risk-reducing factor for CHDs. We investigated the association between periconceptional intake of folic acid supplements and infant risk of CHDs. METHODS: Information on maternal intake of folic acid supplements before and during pregnancy in the Medical Birth Registry of Norway 1999-2009 was updated with information on CHD diagnoses from national health registers and the Cardiovascular Diseases in Norway Project. The association between folic acid intake and infant risk of CHD was estimated as relative risk (RR) with binomial log linear regression. RESULTS: Among 517 784 non-chromosomal singleton births, 6200 children were identified with CHD and 1153 with severe CHD. For all births, 18.4% of the mothers initiated folic acid supplements before pregnancy and 31.6% during pregnancy. The adjusted RR for severe CHD was 0.99 [95% confidence interval [CI] 0.86, 1.13] comparing periconceptional intake of folic acid with no intake. Specifically, RR for conotruncal defects was 0.99 [95% CI 0.80, 1.22], atrioventricular septal defects 1.19 [95% CI 0.78, 1.81], left ventricular outflow tract obstructions 1.02 [95% CI 0.78, 1.32], and right ventricular outflow tract obstructions 0.97 [95% CI 0.72, 1.29]. Birth prevalence of septal defects was higher in the group exposed to folic acid supplements with RR 1.19 [95% CI 1.10, 1.30]. CONCLUSIONS: Periconceptional folic acid supplement use showed no association with severe CHDs in the newborn. An unexpected association with an increased risk of septal defects warrants further investigation.
BACKGROUND: The birth prevalence of congenital heart defects (CHDs) has decreased in Canada and Europe. Recommended intake of folic acid in pregnancy is a suggestive risk-reducing factor for CHDs. We investigated the association between periconceptional intake of folic acid supplements and infant risk of CHDs. METHODS: Information on maternal intake of folic acid supplements before and during pregnancy in the Medical Birth Registry of Norway 1999-2009 was updated with information on CHD diagnoses from national health registers and the Cardiovascular Diseases in Norway Project. The association between folic acid intake and infant risk of CHD was estimated as relative risk (RR) with binomial log linear regression. RESULTS: Among 517 784 non-chromosomal singleton births, 6200 children were identified with CHD and 1153 with severe CHD. For all births, 18.4% of the mothers initiated folic acid supplements before pregnancy and 31.6% during pregnancy. The adjusted RR for severe CHD was 0.99 [95% confidence interval [CI] 0.86, 1.13] comparing periconceptional intake of folic acid with no intake. Specifically, RR for conotruncal defects was 0.99 [95% CI 0.80, 1.22], atrioventricular septal defects 1.19 [95% CI 0.78, 1.81], left ventricular outflow tract obstructions 1.02 [95% CI 0.78, 1.32], and right ventricular outflow tract obstructions 0.97 [95% CI 0.72, 1.29]. Birth prevalence of septal defects was higher in the group exposed to folic acid supplements with RR 1.19 [95% CI 1.10, 1.30]. CONCLUSIONS: Periconceptional folic acid supplement use showed no association with severe CHDs in the newborn. An unexpected association with an increased risk of septal defects warrants further investigation.
Authors: Patrick Y Jay; Ehiole Akhirome; Rachel A Magnan; M Rebecca Zhang; Lillian Kang; Yidan Qin; Nelson Ugwu; Suk Dev Regmi; Julie M Nogee; James M Cheverud Journal: Mol Cell Endocrinol Date: 2016-08-20 Impact factor: 4.102
Authors: Shiliang Liu; K S Joseph; Wei Luo; Juan Andrés León; Sarka Lisonkova; Michiel Van den Hof; Jane Evans; Ken Lim; Julian Little; Reg Sauve; Michael S Kramer Journal: Circulation Date: 2016-08-30 Impact factor: 29.690