Occurrence of Congenital Heart Defects in Relation to Maternal Multivitamin Use

• Published in: American journal of epidemiology Vol. 151; no. 9; pp. 878 - 884
• Main Authors: Botto, Lorenzo D., Mulinare, Joseph, Erickson, J. David
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01.05.2000
• Subjects: abnormalities; Biological and medical sciences; Cardiology. Vascular system; congenital; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Heart; heart defects; heart septal defects; Medical sciences; ventricular; vitamins; United States; North America; America; Human; Congenital; Use; Vitamin; Cardiovascular disease; Case control study; Congenital disease; Epidemiology; Pregnancy; Prevention; Newborn; Mother; Diet; Heart disease; Risk factor; Supplementation; Public health
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a010291

The purpose of this study was to assess the relation between maternal multivitamin use and risk for cardiac defects in the offspring, using a population-based approach. The Atlanta Birth Defects Case-Control study is a population-based case-control study of infants born between 1968 and 1980 to mothers residing in metropolitan Atlanta, Georgia. The 958 case infants with nonsyndromic cardiac defects were actively ascertained from multiple sources. The 3, 029 infants without birth defects (control infants) were selected from birth certificates by stratified random sampling. Periconceptional multivitamin use, defined as reported regular use of multivitamins from 3 months before pregnancy through the first 3 months of pregnancy, was contrasted with no use during the same time period. Periconceptional multivitamin use was associated with a reduced risk for nonsyndromic cardiac defects in the offspring (odds ratio (OR) = 0.76; 95% confidence interval (Cl): 0.60, 0.97). The risk reduction was strongest for outflow tract defects (OR = 0.46; 95% Cl: 0.24, 0.86) and ventricular septal defects (OR = 0.61; 95% Cl: 0.38, 0.99). No risk reduction was evident when multivitamin use was begun after the first month of pregnancy. If these associations are causal, the results suggest that approximately one in four major cardiac defects could be prevented by periconceptional multivitamin use. Am J Epidemiol 2000A 51: 878-84.