title: Correlation between congenital heart defects and maternal copper and zinc concentrations.
abstract: BACKGROUND
  The aim of this study was to investigate the correlation between maternal concentrations of copper and zinc and the risk of having an infant with a congenital heart defect (CHD).
  
  
  METHODS
  A multi-center hospital-based case-control study was conducted in China. A total of 212 cases and 212 controls were recruited from pregnant women who received prenatal examinations in four tertiary hospitals accredited to perform prenatal diagnosis in the cities of Shenzhen, Zhenzhou, Fuzhou and Wuhan between February 2010 and November 2011. Correlation between CHDs and maternal copper and zinc concentrations was estimated by a 1:1 conditional logistic regression. Also the interaction between copper and zinc was analyzed.
  
  
  RESULTS
  Compared with the controls, mothers with hair copper concentrations of 17.77 μg/g or more were more likely to have a child with a CHD than those with a lower concentration. The adjusted odds ratio was 5.70 (95% confidence interval, 2.58-12.61) for CHDs and 6.32 (95% confidence interval, 2.11-18.92) for conotruncal defects. Zinc concentrations were not significantly different in the case and control groups. The results suggest that mothers whose zinc content was 104.60 μg/g or less did not have a significantly higher risk of having a child with a CHD. No interaction between maternal copper and zinc concentrations was observed in the multiplicative or additive model.
  
  
  CONCLUSIONS
  Women with excessive copper concentrations have a significantly increased risk of having offspring with a CHD. A low maternal zinc status might have a correlation with CHDs, and an interaction between copper and zinc might exists, but an epidemiological study with a larger sample size is needed to confirm this finding.
authors.affiliation: National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Hu
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Shengli
authors.initials: S
authors.lastname: Li
authors.forename: Xiaoxian
authors.initials: X
authors.lastname: Tian
authors.forename: Yuan
authors.initials: Y
authors.lastname: Lin
authors.forename: Xinlin
authors.initials: X
authors.lastname: Chen
authors.forename: Jiaxiang
authors.initials: J
authors.lastname: Yang
authors.forename: Ying
authors.initials: Y
authors.lastname: Deng
authors.forename: Nana
authors.initials: N
authors.lastname: Li
authors.forename: Yanping
authors.initials: Y
authors.lastname: Wang
authors.forename: Ping
authors.initials: P
authors.lastname: Yuan
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003300:Copper / Q000378:metabolism*; D005260:Female; D005865:Gestational Age; D006197:Hair / Q000737:chemistry*; D006330:Heart Defects, Congenital / Q000139:chemically induced* / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D013058:Mass Spectrometry; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000378:metabolism; D012307:Risk Factors; D015032:Zinc / Q000378:metabolism*
chemical_list: D003300:Copper; D015032:Zinc
keywords: Congenital Heart Defect; Pregnancy; hair analysis; zinc and copper concentrations