Maternal folic acid supplementation and dietary folate intake and congenital heart defects.
Maternal folic acid supplementation and dietary folate intake and congenital heart defects.
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DOI：
10.1371/journal.pone.0187996
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Zhang Y
中科院分区：
文献类型：
--
作者：
Mao B;Qiu J;Zhao N;Shao Y;Dai W;He X;Cui H;Lin X;Lv L;Tang Z;Xu S;Huang H;Zhou M;Xu X;Qiu W;Liu Q;Zhang Y
据报道，怀孕前和/或怀孕期间补充叶酸可以降低先天性心脏缺陷（CHDs）的风险。然而，有限的流行病学研究结果尚无定论。我们调查了母体叶酸补充、膳食叶酸摄入和冠心病风险之间的关系。2010-2012年在中国兰州甘肃省妇幼保健院进行了一项出生队列研究。在排除死产和多胎后，共有94名新生儿被确定为先天性心脏缺陷，9993名新生儿没有任何出生缺陷。使用无条件逻辑回归来估计相关性。与不服用叶酸补充剂的人相比，怀孕前服用叶酸补充剂的人患冠心病的风险降低（OR: 0.42, 95% CI: 0.21-0.86， p趋势= 0.025）。观察到对某些亚型冠心病的保护作用（OR: 0.37, 95% CI：大动脉畸形0.16-0.85；心间隔畸形0.26,0.10-0.68；房间隔缺损0.34,0.13-0.93）。对多种冠心病也有类似的保护作用（OR: 0.49, 95% CI: 0.26-0.93, Ptrend = 0.004）。与饮食中叶酸摄入量的中间四分位数相比，怀孕期间饮食中叶酸摄入量较低（<149.88 μg/d）与总体冠心病（OR: 1.63, 95% CI: 1.01-2.62）和动脉导管未闭（OR: 1.85, 95% CI: 1.03-3.32）的风险增加相关。不服用叶酸补充剂和饮食中叶酸摄入量较低的妇女其后代患冠心病的风险几乎增加了两倍。我们的研究表明，怀孕前补充叶酸与降低冠心病的风险有关，而怀孕期间饮食中叶酸摄入量较低则与风险增加有关。观察到的相关性因冠心病亚型而异。此外，还观察到膳食叶酸摄入量和叶酸补充的协同效应。
It has been reported that folic acid supplementation before and/or during pregnancy could reduce the risk of congenital heart defects (CHDs). However, the results from limited epidemiologic studies have been inconclusive. We investigated the associations between maternal folic acid supplementation, dietary folate intake, and the risk of CHDs. A birth cohort study was conducted in 2010–2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China. After exclusion of stillbirths and multiple births, a total of 94 births were identified with congenital heart defects, and 9,993 births without any birth defects. Unconditional logistic regression was used to estimate the associations. Compared to non-users, folic acid supplement users before pregnancy had a reduced risk of overall CHDs (OR: 0.42, 95% CI: 0.21–0.86, Ptrend = 0.025) after adjusted for potential confounders. A protective effect was observed for certain subtypes of CHDs (OR: 0.37, 95% CI: 0.16–0.85 for malformation of great arteries; 0.26, 0.10–0.68 for malformation of cardiac septa; 0.34, 0.13–0.93 for Atrial septal defect). A similar protective effect was also seen for multiple CHDs (OR: 0.49, 95% CI: 0.26–0.93, Ptrend = 0.004). Compared with the middle quartiles of dietary folate intake, lower dietary folate intake (<149.88 μg/day) during pregnancy were associated with increased risk of overall CHDs (OR: 1.63, 95% CI: 1.01–2.62) and patent ductus arteriosus (OR: 1.85, 95% CI: 1.03–3.32). Women who were non-user folic acid supplement and lower dietary folate intake have almost 2-fold increased CHDs risk in their offspring. Our study suggested that folic acid supplementation before pregnancy was associated with a reduced risk of CHDs, lower dietary folate intake during pregnancy was associated with increased risk. The observed associations varied by CHD subtypes. A synergistic effect of dietary folate intake and folic acid supplementation was also observed.
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影响因子：
5
作者：
Smedts, Huberdina P. M.;Rakhshandehroo, Maryam;Steegers-Theunissen, Regine P. M.
通讯作者：
Steegers-Theunissen, Regine P. M.
DOI：
10.3109/14767058.2012.755170
发表时间：
2013-05-01
影响因子：
1.8
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
3.7
作者：
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通讯作者：
Gao XM
DOI：
10.1136/bmj.b1673
发表时间：
2009-05-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Ionescu-Ittu R;Marelli AJ;Mackie AS;Pilote L
通讯作者：
Pilote L