Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Birth Defects Res. 2018 Jun 1;110(10):863-870. doi: 10.1002/bdr2.1201. Epub 2018 Mar 5.
We previously explored associations between nutrients including folate and other macro and micronutrients and risks of anophthalmia or microphthalmia in the National Birth Defects Prevention Study. In the current study, we expand those previous results with larger sample sizes and conduct analyses with an additional diet quality index using more recent data.
The National Birth Defects Prevention Study is a population-based, multicenter case-control study of over 30 major birth defects, with estimated due dates from October 1997 to December 2011. Cases were 224 infants diagnosed with anophthalmia or microphthalmia. Controls were 11,109 live-born, nonmalformed infants randomly selected by each study center. Mothers completed a standardized, computer-assisted telephone interview between 6 weeks and 24 months after delivery. Mothers responded to a shortened food frequency questionnaire, assessing their nutrient intake for the year before pregnancy, and questions about periconceptional (2 months before to 2 months after conception) vitamin supplement use. Nutrient intake quartiles were based on the intake among controls.
Among vitamin supplement users, odds of anophthalmia/microphthalmia were decreased for women with intake levels in the highest quartile of folate (0.56, 95% confidence interval [CI] 0.32-0.98), magnesium (0.42, 95% CI 0.22-0.82), and vitamin E (0.50, 95% CI 0.29-0.89). Among women not reporting vitamin supplement use, the odds were significantly increased for beta-carotene (2.5, 95% CI 1.10-5.68) and decreased for retinol (0.37, 95% CI 0.19-0.73).
In this expanded analysis, we observed associations for a few nutrients, specifically forms of vitamin A. However, the heterogeneity of results by form and vitamin use necessitates further inquiry.
我们之前在全国出生缺陷预防研究中探讨了包括叶酸在内的营养物质以及其他宏量和微量营养素与无眼症或小眼症风险之间的关联。在当前的研究中，我们使用更大的样本量扩展了之前的结果，并使用新的更近期的数据进行了额外的饮食质量指数分析。
全国出生缺陷预防研究是一项基于人群的多中心病例对照研究，研究了 30 多种主要出生缺陷，估计预产期为 1997 年 10 月至 2011 年 12 月。病例为 224 名被诊断为无眼症或小眼症的婴儿。对照组为每个研究中心随机选择的 11109 名活产、无畸形的婴儿。母亲在分娩后 6 周到 24 个月之间完成了标准化的、计算机辅助的电话访谈。母亲回答了一个简化的食物频率问卷，评估了她们在怀孕前一年的营养素摄入量，以及关于围孕期（受孕前 2 个月至受孕后 2 个月）维生素补充剂使用的问题。营养素摄入量四分位距是基于对照组的摄入量确定的。
在使用维生素补充剂的女性中，叶酸（四分位距最高组的 OR=0.56，95%CI 0.32-0.98）、镁（OR=0.42，95%CI 0.22-0.82）和维生素 E（OR=0.50，95%CI 0.29-0.89）摄入量最高四分位距的女性发生无眼症/小眼症的几率降低。在未报告使用维生素补充剂的女性中，β-胡萝卜素（OR=2.5，95%CI 1.10-5.68）的几率显著增加，视黄醇（OR=0.37，95%CI 0.19-0.73）的几率降低。
在这项扩展分析中，我们观察到了一些营养素，特别是维生素 A 的形式与结果之间的关联。然而，形式和维生素使用的结果存在异质性，需要进一步研究。
