Pace Nelson D, Desrosiers Tania A, Carmichael Suzan L, Shaw Gary M, Olshan Andrew F, Siega-Riz Anna Maria
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Department of Pediatrics, Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA.
Paediatr Perinat Epidemiol. 2018 Jan;32(1):90-99. doi: 10.1111/ppe.12403. Epub 2017 Sep 4.
Approximately 1 in 2000 infants is born with a limb deficiency in the US. Research has shown that women's periconceptional diet and use of vitamin supplements can affect risk of birth defects. We investigated whether maternal consumption of nutritional antioxidants was associated with occurrence of transverse limb deficiency (TLD) and longitudinal limb deficiencies (LLD).
We analysed case-control data from mothers and their singleton infants with TLD (n = 566), LLD (n = 339), or no malformation (controls; n = 9384) in the National Birth Defects Prevention Study (1997-2009). Using a modified food frequency, we estimated usual pre-pregnancy antioxidant consumption by total fruit and vegetable consumption (in grams) grouped into tertiles, and cumulative antioxidant score (ranging from 1 to 10) based on consumption of three antioxidants: beta-carotene, lycopene, and lutein. We estimated odds ratios (OR) adjusted for maternal age, race/ethnicity, education, smoking, alcohol use, body mass index, and total energy.
Compared to women in the lowest tertile of fruit and vegetable consumption, women in the highest tertile were less likely to have infants with TLD (OR 0.74, 95% CI 0.57, 0.96) or LLD (OR 0.82, 95% CI 0.59, 1.13). Compared to the lowest antioxidant consumption score of 1, those with the highest score of 10 had ORs of 0.68 (95% CI 0.48, 0.95) for TLD and 0.77 (95% CI 0.50, 1.17) for LLD.
Dietary intake of antioxidants was associated with reduced odds of limb deficiencies. These findings add further evidence for women's periconceptional diet reducing occurrence of some birth defects.
在美国,每2000名婴儿中约有1名出生时肢体存在缺陷。研究表明,女性受孕前后的饮食和维生素补充剂的使用会影响出生缺陷的风险。我们调查了母亲摄入营养抗氧化剂是否与横向肢体缺陷(TLD)和纵向肢体缺陷(LLD)的发生有关。
我们分析了国家出生缺陷预防研究(1997 - 2009年)中母亲及其单胎婴儿的数据,这些婴儿患有TLD(n = 566)、LLD(n = 339)或无畸形(对照组;n = 9384)。使用改良的食物频率,我们通过将总水果和蔬菜摄入量(以克为单位)分为三分位数来估计孕前抗氧化剂的通常摄入量,并根据β-胡萝卜素、番茄红素和叶黄素三种抗氧化剂的摄入量计算累积抗氧化剂得分(范围为1至10)。我们估计了经产妇年龄、种族/民族、教育程度、吸烟、饮酒、体重指数和总能量调整后的比值比(OR)。
与水果和蔬菜摄入量最低三分位数的女性相比,最高三分位数的女性生育患有TLD婴儿的可能性较小(OR 0.74,95% CI 0.57,0.96)或LLD婴儿的可能性较小(OR 0.82,95% CI 0.59,1.13)。与最低抗氧化剂消费得分1相比,得分最高为10的人患TLD的OR为0.68(95% CI 0.48,0.95),患LLD的OR为0.77(95% CI 0.50,1.17)。
抗氧化剂的饮食摄入量与肢体缺陷几率降低有关。这些发现进一步证明了女性受孕前后的饮食可减少某些出生缺陷的发生。