First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study
Background Maternal folic acid supplementation (FAS) reduces the risk of neural tube defects in offspring. However, its effect on congenital heart disease (CHDs), especially on the severe ones remains uncertain. This study aimed to assess the individual and joint effect of first‐trimester maternal F...
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015652 |
| _version_ | 1811333998025113600 |
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| author | Yanji Qu Shao Lin Jian Zhuang Michael S. Bloom Maggie Smith Zhiqiang Nie Jinzhuang Mai Yanqiu Ou Yong Wu Xiangmin Gao Hongzhuan Tan Xiaoqing Liu |
| author_facet | Yanji Qu Shao Lin Jian Zhuang Michael S. Bloom Maggie Smith Zhiqiang Nie Jinzhuang Mai Yanqiu Ou Yong Wu Xiangmin Gao Hongzhuan Tan Xiaoqing Liu |
| author_sort | Yanji Qu |
| collection | DOAJ |
| description | Background Maternal folic acid supplementation (FAS) reduces the risk of neural tube defects in offspring. However, its effect on congenital heart disease (CHDs), especially on the severe ones remains uncertain. This study aimed to assess the individual and joint effect of first‐trimester maternal FAS and multivitamin use on CHDs in offspring. Methods and Results This is a case‐control study including 8379 confirmed CHD cases and 6918 controls from 40 healthcare centers of 21 cities in Guangdong Province, China. Adjusted odds ratios (aORs) of FAS and multivitamin use between CHD cases (overall and specific CHD phenotypes) and controls were calculated by controlling for parental confounders. The multiplicative interaction effect of FAS and multivitamin use on CHDs was estimated. A significantly protective association was detected between first‐trimester maternal FAS and CHDs among offspring (aOR, 0.69; 95% CI, 0.62–0.76), but not for multivitamin use alone (aOR, 1.42; 95% CI, 0.73–2.78). There was no interaction between FAS and multivitamin use on CHDs (P=0.292). Most CHD phenotypes benefited from FAS (aORs ranged from 0.03–0.85), especially the most severe categories (ie, multiple critical CHDs [aOR, 0.16; 95% CI, 0.12–0.22]) and phenotypes (ie, single ventricle [aOR, 0.03; 95% CI, 0.004–0.21]). Conclusions First‐trimester maternal FAS, but not multivitamin use, was substantially associated with lower risk of CHDs, and the association was strongest for the most severe CHD phenotypes. We recommend that women of childbearing age should supplement with folic acid as early as possible, ensuring coverage of the critical window for fetal heart development to prevent CHDs. |
| first_indexed | 2024-04-13T17:01:15Z |
| format | Article |
| id | doaj.art-4b8028718171445182ee0e8f0c154496 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:01:15Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-4b8028718171445182ee0e8f0c1544962022-12-22T02:38:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-07-0191310.1161/JAHA.119.015652First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control StudyYanji Qu0Shao Lin1Jian Zhuang2Michael S. Bloom3Maggie Smith4Zhiqiang Nie5Jinzhuang Mai6Yanqiu Ou7Yong Wu8Xiangmin Gao9Hongzhuan Tan10Xiaoqing Liu11Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha Hunan ChinaDepartment of Environmental Health SciencesUniversity at AlbanyState University of New York Rensselaer NYGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaDepartment of Environmental Health SciencesUniversity at AlbanyState University of New York Rensselaer NYDepartment of Environmental Health SciencesUniversity at AlbanyState University of New York Rensselaer NYGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaDepartment of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha Hunan ChinaGuangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong ChinaBackground Maternal folic acid supplementation (FAS) reduces the risk of neural tube defects in offspring. However, its effect on congenital heart disease (CHDs), especially on the severe ones remains uncertain. This study aimed to assess the individual and joint effect of first‐trimester maternal FAS and multivitamin use on CHDs in offspring. Methods and Results This is a case‐control study including 8379 confirmed CHD cases and 6918 controls from 40 healthcare centers of 21 cities in Guangdong Province, China. Adjusted odds ratios (aORs) of FAS and multivitamin use between CHD cases (overall and specific CHD phenotypes) and controls were calculated by controlling for parental confounders. The multiplicative interaction effect of FAS and multivitamin use on CHDs was estimated. A significantly protective association was detected between first‐trimester maternal FAS and CHDs among offspring (aOR, 0.69; 95% CI, 0.62–0.76), but not for multivitamin use alone (aOR, 1.42; 95% CI, 0.73–2.78). There was no interaction between FAS and multivitamin use on CHDs (P=0.292). Most CHD phenotypes benefited from FAS (aORs ranged from 0.03–0.85), especially the most severe categories (ie, multiple critical CHDs [aOR, 0.16; 95% CI, 0.12–0.22]) and phenotypes (ie, single ventricle [aOR, 0.03; 95% CI, 0.004–0.21]). Conclusions First‐trimester maternal FAS, but not multivitamin use, was substantially associated with lower risk of CHDs, and the association was strongest for the most severe CHD phenotypes. We recommend that women of childbearing age should supplement with folic acid as early as possible, ensuring coverage of the critical window for fetal heart development to prevent CHDs.https://www.ahajournals.org/doi/10.1161/JAHA.119.015652congenital heart diseasefolatemultivitaminpregnancyprevention |
| spellingShingle | Yanji Qu Shao Lin Jian Zhuang Michael S. Bloom Maggie Smith Zhiqiang Nie Jinzhuang Mai Yanqiu Ou Yong Wu Xiangmin Gao Hongzhuan Tan Xiaoqing Liu First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease congenital heart disease folate multivitamin pregnancy prevention |
| title | First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study |
| title_full | First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study |
| title_fullStr | First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study |
| title_full_unstemmed | First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study |
| title_short | First‐Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case‐Control Study |
| title_sort | first trimester maternal folic acid supplementation reduced risks of severe and most congenital heart diseases in offspring a large case control study |
| topic | congenital heart disease folate multivitamin pregnancy prevention |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015652 |
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