title: Lower rate of selected congenital heart defects with better maternal diet quality: a population-based study.
abstract: OBJECTIVE
  To evaluate whether better diet quality in mothers is associated with lower risk for major non-syndromic congenital heart defects in their children.
  
  
  METHODS
  Multicentre population-based case-control study, the National Birth Defects Prevention Study.
  
  
  METHODS
  Ten sites in the USA.
  
  
  METHODS
  Mothers of babies with major non-syndromic congenital heart defects (n=9885) and mothers with unaffected babies (n=9468) with estimated date of delivery from 1997 to 2009.
  
  
  METHODS
  Adjusted ORs for specific major congenital heart defects by quartiles of maternal diet quality in the year before pregnancy, assessed by the Diet Quality Index for pregnancy (DQI-P) and the Mediterranean Diet Score. Quartile 1 (Q1) reflecting the worst diet quality and Q4 the best diet quality.
  
  
  RESULTS
  Better diet quality was associated with reduced risk for some conotruncal and atrial septal heart defects. For DQI-P, estimated risks reductions (Q4 vs Q1) for conotruncal defects were 37% for tetralogy of Fallot (OR 0.63, 95% CI 0.49 to 0.80) and 24% overall (OR 0.76, 95% CI 0.64 to 0.91); and for septal defects, 23% for atrial septal defects (OR 0.77, 95% CI 0.63 to 0.94) and 14% overall (OR 0.86, 95% CI 0.75 to 1.00). Risk reductions were weaker or minimal for most other major congenital heart defects.
  
  
  CONCLUSIONS
  Better diet quality is associated with a reduced occurrence of some conotruncal and septal heart defects. This finding suggests that a reduction in certain cardiac malformations may be an additional benefit of improved maternal diet quality, reinforcing current preconception care recommendations.
authors: Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
authors: Lorenzo D
authors: LD
authors: Botto
authors: Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
authors: Sergey
authors: S
authors: Krikov
authors: Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
authors: Suzan L
authors: SL
authors: Carmichael
authors: Department of Nutrition and Food Sciences, Utah State University, Logan, Utah, USA.
authors: Ronald G
authors: RG
authors: Munger
authors: Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
authors: Gary M
authors: GM
authors: Shaw
authors: Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
authors: Marcia L
authors: ML
authors: Feldkamp
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004032:Diet / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cardiology; Congenital Abnorm; Epidemiology