Maternal Dietary Patterns during Pregnancy and Congenital Heart Defects: A Case-Control Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Dietary Assessment
2.3. Covariables
2.4. Statistical Analysis
3. Results
3.1. Population Characteristics
3.2. Dietary Patterns
3.3. Dietary Patterns and the Risk of Congenital Heart Defects
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Case (N = 474) | Control (N = 948) | p * |
---|---|---|---|
Socio-demographic characteristics, n (%) | |||
Maternal age ≥ 30 years | 159 (33.5) | 324 (34.2) | 0.812 |
Rural residence | 161 (34.0) | 269 (28.4) | 0.030 |
Maternal occupation, farmers | 234 (49.5) | 201 (21.0) | <0.001 |
Maternal education, junior high school or below | 195 (41.1) | 183 (19.3) | <0.001 |
Nulliparity | 274 (57.8) | 761 (80.3) | <0.001 |
Maternal health-related factors during the first trimester, n (%) | |||
Folate supplements use | 292 (61.6) | 751 (79.2) | <0.001 |
Anemia | 80 (16.9) | 103 (10.9) | 0.001 |
Passive smoking | 159 (33.5) | 88 (9.3) | <0.001 |
Medication use | 197 (41.6) | 288 (30.4) | <0.001 |
Neonatal gender, male, n (%) | 248 (52.3) | 471 (49.7) | 0.348 |
Daily nutrient intakes during pregnancy, mean (SD) | |||
Energy (kcal) | 1860.5 (868.0) | 2044.8 (954.4) | 0.001 |
Folate (μg) | 219.4 (93.4) | 244.2 (92.5) | 0.146 |
Calcium (mg) | 421.9 (187.9) | 561.6 (209.5) | 0.102 |
Iron (mg) | 19.1 (8.7) | 22.9 (10.9) | <0.001 |
Dietary Pattern | Food Groups | Factor Loading | Variance Explained, % | Cumulated Variance Explained, % |
---|---|---|---|---|
Prudent pattern | 31.22 | 31.22 | ||
Red meats | 0.77 | |||
White meats | 0.73 | |||
Legumes | 0.59 | |||
Vegetables | 0.55 | |||
Snacks 2 | 0.50 | |||
Dairy | 0.28 | |||
Vegetarian pattern | 11.92 | 43.14 | ||
Cereals and tubers | 0.71 | |||
Fruits | 0.66 | |||
Vegetables | 0.56 | |||
Nuts | 0.51 | |||
Snacks 2 | 0.51 | |||
Legumes | 0.30 | |||
Dairy and egg pattern | 9.25 | 53.39 | ||
Dairy | 0.68 | |||
Eggs | 0.68 | |||
Nuts | 0.45 | |||
Beverages | −0.41 |
Dietary Patterns | Total CHDs (Ncases = 474) | VSD (Ncases = 222) | ASD (Ncases = 218) | |||
---|---|---|---|---|---|---|
Cases/Controls | Model 1 OR 1 (95%CI) | Model 2 OR 2 (95%CI) | Model 3 OR 3 (95%CI) | Model 3 OR 3 (95%CI) | Model 3 OR 3 (95%CI) | |
Prudent pattern | ||||||
Tertile 1 | 231/316 | 1 | 1 | 1 | 1 | 1 |
Tertile 2 | 132/316 | 0.63 (0.45, 0.88) | 0.79 (0.56, 1.13) | 0.77 (0.53, 1.12) | 0.82 (0.50, 1.32) | 0.77 (0.48, 1.24) |
Tertile 3 | 111/316 | 0.60 (0.46, 0.79) | 0.68 (0.51, 0.90) | 0.65 (0.48, 0.89) | 0.75 (0.51, 1.11) | 0.65 (0.44, 0.97) |
ptrend 4 | 0.015 | 0.086 | 0.080 | 0.326 | 0.191 | |
Vegetarian pattern | ||||||
Tertile 1 | 121/316 | 1 | 1 | 1 | 1 | 1 |
Tertile 2 | 196/316 | 1.96 (1.47, 2.62) | 1.57 (1.17, 2.14) | 1.50 (1.03, 2.17) | 1.97 (1.18, 3.29) | 1.31 (0.80, 2.14) |
Tertile 3 | 157/316 | 2.36 (1.67, 3.34) | 1.67 (1.17, 2.38) | 1.56 (1.13, 2.15) | 2.01 (1.31, 3.09) | 1.63 (1.08, 2.46) |
ptrend 4 | <0.001 | 0.003 | 0.015 | 0.004 | 0.156 | |
Dairy and egg pattern | ||||||
Tertile 1 | 244/316 | 1 | 1 | 1 | 1 | 1 |
Tertile 2 | 124/316 | 0.53 (0.41, 0.70) | 0.63 (0.47, 0.84) | 0.66 (0.49, 0.90) | 0.63 (0.42, 0.95) | 0.58 (0.40, 0.86) |
Tertile 3 | 106/316 | 0.48 (0.36, 0.64) | 0.56 (0.41, 0.75) | 0.60 (0.43, 0.82) | 0.61 (0.41, 0.93) | 0.46 (0.30, 0.70) |
ptrend 4 | <0.001 | <0.001 | 0.001 | 0.014 | <0.001 |
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Yang, J.; Kang, Y.; Cheng, Y.; Zeng, L.; Yan, H.; Dang, S. Maternal Dietary Patterns during Pregnancy and Congenital Heart Defects: A Case-Control Study. Int. J. Environ. Res. Public Health 2019, 16, 2957. https://doi.org/10.3390/ijerph16162957
Yang J, Kang Y, Cheng Y, Zeng L, Yan H, Dang S. Maternal Dietary Patterns during Pregnancy and Congenital Heart Defects: A Case-Control Study. International Journal of Environmental Research and Public Health. 2019; 16(16):2957. https://doi.org/10.3390/ijerph16162957
Chicago/Turabian StyleYang, Jiaomei, Yijun Kang, Yue Cheng, Lingxia Zeng, Hong Yan, and Shaonong Dang. 2019. "Maternal Dietary Patterns during Pregnancy and Congenital Heart Defects: A Case-Control Study" International Journal of Environmental Research and Public Health 16, no. 16: 2957. https://doi.org/10.3390/ijerph16162957