Gilboa Suzanne M, Lee Kyung A, Cogswell Mary E, Traven Flavia K, Botto Lorenzo D, Riehle-Colarusso Tiffany, Correa Adolfo, Boyle Coleen A
Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
Birth Defects Res A Clin Mol Teratol. 2014 Sep;100(9):647-57. doi: 10.1002/bdra.23247. Epub 2014 Apr 17.
In a recent study, high maternal periconceptional intake of vitamin E was found to be associated with risk of congenital heart defects (CHDs). To explore this association further, we investigated the association between total daily vitamin E intake and selected birth defects.
We analyzed data from 4525 controls and 8665 cases from the 1997 to 2005 National Birth Defects Prevention Study. We categorized estimated periconceptional energy-adjusted total daily vitamin E intake from diet and supplements into quartiles (referent, lowest quartile). Associations between quartiles of energy-adjusted vitamin E intake and selected birth defects were adjusted for demographic, lifestyle, and nutritional factors.
We observed a statistically significant association with the third quartile of vitamin E intake (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01-1.35) and all CHDs combined. Among CHD sub-types, we observed associations with left ventricular outflow tract obstruction defects, and its sub-type, coarctation of the aorta and the third quartile of vitamin E intake. Among defects other than CHDs, we observed associations between anorectal atresia and the third quartile of vitamin E intake (OR, 1.66; 95% CI, 1.01-2.72) and hypospadias and the fourth quartile of vitamin E intake (OR, 1.42; 95% CI, 1.09-1.87).
Selected quartiles of energy-adjusted estimated total daily vitamin E intake were associated with selected birth defects. However, because these few associations did not exhibit exposure-response patterns consistent with increasing risk associated with increasing intake of vitamin E, further studies are warranted to corroborate our findings.
在最近一项研究中,发现孕期维生素E摄入量高与先天性心脏病(CHD)风险相关。为进一步探究这种关联,我们调查了每日维生素E总摄入量与特定出生缺陷之间的关联。
我们分析了1997年至2005年全国出生缺陷预防研究中4525名对照和8665例病例的数据。我们将通过饮食和补充剂摄入的孕期能量调整后每日维生素E总摄入量分为四分位数(参照组为最低四分位数)。对能量调整后的维生素E摄入量四分位数与特定出生缺陷之间的关联进行了人口统计学、生活方式和营养因素的校正。
我们观察到维生素E摄入量第三四分位数与所有先天性心脏病合并症之间存在统计学显著关联(优势比[OR]为1.17;95%置信区间[CI]为1.01 - 1.35)。在先天性心脏病亚型中,我们观察到左心室流出道梗阻缺陷及其亚型主动脉缩窄与维生素E摄入量第三四分位数之间存在关联。在非先天性心脏病的缺陷中,我们观察到肛门直肠闭锁与维生素E摄入量第三四分位数之间存在关联(OR为1.66;95%CI为1.01 - 2.72),尿道下裂与维生素E摄入量第四四分位数之间存在关联(OR为1.42;95%CI为1.09 - 1.87)。
能量调整后的每日维生素E估计总摄入量的特定四分位数与特定出生缺陷相关。然而,由于这些少数关联未表现出与维生素E摄入量增加相关的风险增加一致的暴露 - 反应模式,因此需要进一步研究来证实我们的发现。