Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland.
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland.
Nutrients. 2024 Sep 6;16(17):3024. doi: 10.3390/nu16173024.
The available data on the relationship between diet/folic acid and congenital heart disease (CHD) are not consistent. This study aimed to investigate the relationship between the intake and supplementation of folic acid and other selected factors in mothers and the risk of congenital heart defects in fetuses.
A case-control study was conducted. The study group included pregnant women with fetuses from singleton pregnancies with prenatally diagnosed heart defects in the fetus ( = 79) and pregnant women whose course of pregnancy was normal with no heart defects or other developmental anomalies diagnosed in the fetus ( = 121). The patients were diagnosed at a reference center in Poland. The women completed a lifestyle questionnaire and and precisely described their use of dietary supplements. A univariate logistic regression model was used to evaluate the association between folic acid and selected risk factors and CHD. The association was significant and included such risk factors such as nutritional status, medications taken, smoking, and alcohol consumption. Additionally, the time of starting folic acid supplementation turned out to be statistically significant. The reference period of supplementation was the period before pregnancy.
Lack of supplementation increases the risk of heart defects in children by more than four times compared to supplementation before pregnancy (OR = 4.19; = 0.0117), whereas supplementation beyond the eighth week of gestation increases the risk almost threefold (OR = 2.90; = 0.0474). The presence of congenital defects in the family is also an important factor.
A history of congenital heart defects or other defects, lack of periconceptional folic acid supplementation, and lack of dietary supplementation before pregnancy were associated with congenital heart defects in the fetus. Place of residence, parents' education, lifestyle habits such as smoking and alcohol consumption, nutritional status before pregnancy, and mother's diseases did not show a significant relationship with congenital heart defects in the children. There is an urgent need to develop preventive strategies and conduct extensive public education.
关于饮食/叶酸与先天性心脏病（CHD）之间的关系，现有数据并不一致。本研究旨在探讨母亲叶酸和其他选定因素的摄入量和补充与胎儿先天性心脏缺陷风险之间的关系。
采用病例对照研究。研究组包括在波兰参考中心诊断为胎儿产前诊断为心脏缺陷的单胎妊娠孕妇（n=79）和妊娠过程正常、胎儿无心脏缺陷或其他发育异常的孕妇（n=121）。患者被诊断为。女性完成了生活方式问卷，并详细描述了她们对膳食补充剂的使用情况。采用单变量逻辑回归模型评估叶酸与选定危险因素和 CHD 之间的关联。这种关联是显著的，包括营养状况、服用的药物、吸烟和饮酒等危险因素。此外，开始补充叶酸的时间也具有统计学意义。补充的参考期是怀孕前。
与怀孕前补充相比，缺乏补充会使儿童患心脏病的风险增加四倍以上（OR=4.19；=0.0117），而妊娠 8 周后补充会使风险增加近三倍（OR=2.90；=0.0474）。家族中存在先天性缺陷也是一个重要因素。
先天性心脏病或其他缺陷的病史、缺乏围孕期叶酸补充以及怀孕前缺乏饮食补充与胎儿先天性心脏病有关。居住地点、父母教育程度、吸烟和饮酒等生活方式习惯、怀孕前的营养状况以及母亲的疾病与儿童的先天性心脏病之间没有显示出显著的关系。迫切需要制定预防策略并开展广泛的公众教育。
