Maternal dietary intake of omega 3 fatty acids and birth defects

- -摘要 众所周知，低水平的饮食叶酸与神经系统疾病的风险增加有关。 管缺陷。然而，没有其他膳食营养素与出生缺陷明显相关。我们建议 使用国家出生缺陷预防研究（NBDPS）来评估母亲饮食之间的关联 低欧米伽3脂肪酸和出生缺陷。 NBDPS是最大的基于人口的出生缺陷研究之一， 1997年至2011年期间分娩婴儿的母亲。它包括50个临床明确定义的出生缺陷 表型。饮食信息是使用58项食物频率问卷收集的， Willett及其同事为护士健康研究。 在对NBDPS大约20，000例妊娠数据的初步分析中， 母亲们报告说，她们很少或根本不吃鱼（欧米伽3脂肪酸的主要来源）。该分析 调查了22个出生缺陷，观察到那些只吃1-3份鱼的母亲， 每个月有5个这些出生缺陷的后代的风险较低。另外，一个小案例对照 一项研究发现，食用高含量鱼类食物的母亲患心脏缺陷的风险降低。 我们正在请求支持对40 009例妊娠的NBDPS最终数据库进行分析。 我们将评估三个不同水平的鱼类消费（每月1-3份，1份 每周2份或更多份）和50种不同的出生缺陷表型。我们亦会评估 其他三项母亲摄入欧米伽3脂肪酸的指标与50种出生缺陷之间的关联， 包括两种植物来源的膳食欧米伽3脂肪酸。 该项目包括：1）对多达4，000种膳食补充剂的反应进行编码，2）对200种膳食补充剂进行主要分析， 校正比值比和95%置信区间，3）检验多元回归模型以评估混杂因素 （4）敏感性和偏倚分析。包括2项敏感性分析和误分类分析 偏倚，我们将计算650个调整后的比值比和95%置信区间。 许多妇女很少或根本不吃鱼的观察表明， 美国的鱼类消费量较低，与鱼类消费量相对较高的国家相比， 消费更高。然而，许多妇女不喜欢吃鱼，因为担心环境问题。 这些污染物在其中生物累积。因此，重要的是不仅要了解鱼的影响， 食用欧米茄3脂肪酸对出生缺陷的影响，但也要了解从植物中摄入欧米茄3脂肪酸的影响 出生缺陷的来源。我们假设摄入富含欧米伽3脂肪酸的植物也可能具有保护作用 防止出生缺陷，因此可以作为保护性欧米茄3脂肪酸的替代来源。

-ABSTRACT It is well established that low levels of dietary folic acid are associated with an increased risk of neural tube defects. However, no other dietary nutrient has been clearly associated with birth defects. We propose to use the National Birth Defects Prevention Study (NBDPS) to assess the association between maternal diets low in omega 3 fatty acids and birth defects. The NBDPS, one of the largest population based studies of birth defects, interviewed 40,029 US mothers who delivered infants between 1997 and 2011. It includes 50 clinically well defined birth defect phenotypes. Dietary information was collected using a 58-item food frequency questionnaire developed by Willett and colleagues for The Nurses Health Study. In a preliminary analysis of NBDPS data for approximately 20,000 pregnancies, 31 percent of mothers reported eating little or no fish (a leading source of omega 3 fatty acids). This analysis examined 22 birth defects and observed that mothers who consumed as little as 1-3 servings of fish per month had a lower risk of having offspring with 5 of these birth defects. In addition, a small case control study found that mothers who consume diets high in fish have a reduced risk of heart defects. We are requesting support to undertake analyses of the final NBDPS database of 40,009 pregnancies. We will assess associations between three different levels of fish consumption (1-3 servings per month, 1 serving per week and 2 or more servings per week) and 50 different birth defect phenotypes. We will also assess associations between three other measures of maternal intake of omega 3 fatty acids and 50 birth defects, including two measures of plant sources of dietary omega 3 fatty acids. This project entails 1) coding of responses for up to 4,000 dietary supplements, 2) main analyses of 200 adjusted odds ratios and 95% confidence intervals, 3) testing multiple regression models to evaluate confounding and 4) analyses of sensitivity and bias. Including the 2 sensitivity analyses and the analyses of misclassification bias, we will calculate 650 adjusted odds ratios and 95% confidence intervals. The observation many women eat little or no fish, suggests that the percent of birth defects that may be explained by low fish consumption in the US could be relatively high compared to countries where fish consumption is higher. However, many women prefer not to eat fish because of concerns about the environmental contaminants that bio-accumulate in them. Hence it is important to not only understand the effect of fish consumption on birth defects but to also understand the effect of dietary intake of omega 3 fatty acids from plant sources on birth defects. We hypothesize that intake of plants rich in omega 3 fatty acids may also be protective against birth defects and could therefore serve as an alternative source of protective omega 3 fatty acids.