title: Nutrient intakes in women and congenital diaphragmatic hernia in their offspring.
abstract: BACKGROUND
  Congenital diaphragmatic hernia (CDH) is a severe birth defect where there is an opening in the diaphragm through which a portion of the abdominal contents protrudes into the thoracic cavity. The etiologies of CDH remain unknown, although experimental animal data suggest dietary factors might play a role. This study examined whether maternal nutrient intakes were associated with delivering infants with CDH.
  
  
  METHODS
  We analyzed infants with isolated CDH who were born from 1997 to 2003 and recruited into the National Birth Defects Prevention Study (NBDPS), a multisite, population-based case-control study. Exposure data were obtained from telephone interviews, which were completed within 24 months after delivery, and were available for 377 case mothers and 5,008 control mothers. A food frequency questionnaire was used to derive nutrient intakes during the year before pregnancy.
  
  
  RESULTS
  A crude OR of 0.6 (95% CI: 0.3-1.0) was observed for higher intake of choline. Elevated ORs (1.4 to 1.7) were found for lower intakes of choline, cysteine, methionine, and protein. Among women who took vitamin supplements, higher intakes of B vitamins (i.e., folate, vitamin B1, B2, B6, and B12), minerals (i.e., calcium, iron, magnesium, and zinc), and vitamin E were inversely associated with CDH (ORs from 0.7-0.3). Moreover, among women who did not take vitamin supplements, lower intakes of calcium, retinol, selenium, vitamin B12, and vitamin E had positive associations with CDH (ORs from 1.4 to 2.1).
  
  
  CONCLUSIONS
  Our observations contribute to a limited body of evidence suggesting a woman's periconceptional diet might be associated with CDH in her offspring.
authors.affiliation: March of Dimes, California Research Division, Oakland, California 94609, USA. WYang@marchofdimes.com
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Gary M
authors.initials: GM
authors.lastname: Shaw
authors.forename: Suzan L
authors.initials: SL
authors.lastname: Carmichael
authors.forename: Sonja A
authors.initials: SA
authors.lastname: Rasmussen
authors.forename: D Kim
authors.initials: DK
authors.lastname: Waller
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Pober
authors.forename: Marlene
authors.initials: M
authors.lastname: Anderka
mesh_terms: D016022:Case-Control Studies; D019587:Dietary Supplements; D005260:Female; D006548:Hernia, Diaphragmatic / Q000209:etiology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena; D011795:Surveys and Questionnaires