Folic Acid and Selected Risk Factors for Fetal Heart Defects—Preliminary Study Results

Author:

Kolmaga Agnieszka1,Trafalska Elżbieta1,Gaszyńska Ewelina1ORCID,Murlewska Julia2ORCID,Witkowski Sławomir2ORCID,Sylwestrzak Oskar23,Sokołowski Łukasz23,Respondek-Liberska Maria24ORCID,Strzelecka Iwona24ORCID

Affiliation:

1. Department of Nutrition and Epidemiology, Medical University of Lodz, 90-752 Lodz, Poland

2. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland

3. Department of Gynecology and Obstetrics, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland

4. Department of Diagnoses and Prevention of Fetal Malformations, Medical University of Lodz, 90-419 Lodz, Poland

Abstract

Background: 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. Methods: 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 (n = 79) and pregnant women whose course of pregnancy was normal with no heart defects or other developmental anomalies diagnosed in the fetus (n = 121). The patients were diagnosed at a reference center in Poland. The women completed a lifestyle questionnaire and FFQ 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. Results: Lack of supplementation increases the risk of heart defects in children by more than four times compared to supplementation before pregnancy (OR = 4.19; p = 0.0117), whereas supplementation beyond the eighth week of gestation increases the risk almost threefold (OR = 2.90; p = 0.0474). The presence of congenital defects in the family is also an important factor. Conclusions: 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.

Funder

Medical University of Lodz

Publisher

MDPI AG

Reference95 articles.

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