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母亲孕期维生素 B 摄入和补充与新生儿先天性心脏病的关系:基于倾向评分匹配的病例对照研究。

Maternal B-vitamin intake and B-vitamin supplementation during pregnancy in relation to neonatal congenital heart defects: a case-control study with propensity score matching.

机构信息

Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi Province, China.

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China.

出版信息

Eur J Clin Nutr. 2021 May;75(5):782-791. doi: 10.1038/s41430-020-00804-2. Epub 2020 Nov 16.

Abstract

BACKGROUND/OBJECTIVES: The effect of dietary folate intake or folic acid (FA) supplementation during pregnancy on neonatal congenital heart defects (CHDs) remains inconclusive. There are limited data about non-folate-B-vitamin intake and the risk of CHDs. Furthermore, few studies have investigated dietary B-vitamin intake and B-vitamin supplement use simultaneously in relation to the risk of CHDs. This study aimed to explore the associations between maternal folate, vitamin B, and vitamin B intake (dietary intake, total intake from diet and supplements); B-vitamin supplement use during pregnancy; and the risk of CHDs using the propensity score matching (PSM) method.

METHODS

We conducted a case-control study and included 760 cases and 1600 controls in Shaanxi Province, China. Diet, supplement use and other information were collected through a questionnaire interview. By using the 1:2 ratio PSM method, 396 cases were matched with 792 controls. Conditional logistic regression was used to investigate the associations between maternal B-vitamin intake and supplement use during pregnancy and CHDs.

RESULTS

Higher maternal dietary and total intake of folate and vitamin B were associated with reduced risk of CHDs, and the tests for linear trend were significant. Compared with non-users, maternal FA + VB + VB containing supplement use during pregnancy (OR 0.61, 95%CI 0.40-0.94), FA supplement use during pregnancy (OR 0.70, 95%CI 0.50-0.98) and in the first trimester (OR 0.62, 95%CI 0.46-0.85) were associated with a lower risk of CHDs.

CONCLUSIONS

The findings of this study suggest that a higher intake of folate and vitamin B during pregnancy reduces the risk of CHDs.

摘要

背景/目的:孕期叶酸摄入或叶酸(FA)补充对新生儿先天性心脏病(CHD)的影响仍不确定。关于非叶酸 B 族维生素摄入与 CHD 风险的数据有限。此外,很少有研究同时调查饮食 B 族维生素摄入和 B 族维生素补充剂的使用与 CHD 风险的关系。本研究旨在使用倾向评分匹配(PSM)方法探讨母体叶酸、维生素 B 和维生素 B 摄入(饮食摄入、饮食和补充剂摄入总量)、孕期 B 族维生素补充剂使用与 CHD 风险之间的关系。

方法

我们进行了一项病例对照研究,纳入了中国陕西省的 760 例病例和 1600 例对照。通过问卷调查收集饮食、补充剂使用和其他信息。使用 1:2 比例 PSM 方法,将 396 例病例与 792 例对照相匹配。使用条件逻辑回归分析母体 B 族维生素摄入和孕期补充剂使用与 CHD 之间的关系。

结果

母体叶酸和维生素 B 的饮食和总摄入量较高与 CHD 风险降低相关,线性趋势检验具有统计学意义。与非使用者相比,孕期 FA+VB+VB 复合补充剂(OR 0.61,95%CI 0.40-0.94)、FA 补充剂(OR 0.70,95%CI 0.50-0.98)和孕早期(OR 0.62,95%CI 0.46-0.85)使用与 CHD 风险降低相关。

结论

本研究结果表明,孕期叶酸和维生素 B 摄入较高可降低 CHD 风险。

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