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Maternal use of folic acid and multivitamin supplements and infant risk of birth defects in Norway, 1999-2013.
Br J Nutr. 2020 08 14; 124(3):316-329.BJ

Abstract

The association between folic acid supplementation and birth defects other than neural tube defects (NTD) remains unclear. We used a log-binomial regression model to investigate if periconceptional folic acid and/or multivitamin use was associated with birth defects in Norway with prospectively collected data from the Medical Birth Registry of Norway (MBRN) during 1999-2013. We used the European Surveillance of Congenital Anomalies (EUROCAT) classification system to define eleven organ-specific major birth defect groups (nervous system, eye, ear-face-neck, cardiovascular system, respiratory system, oral clefts, digestive system, abdominal wall, urinary system, genital organs and limb), with additional subgroups. Fetuses or infants whose mothers used folic acid and/or multivitamin supplements before and during pregnancy were classified as exposed. During the years 1999-2013, 888 294 (99·0 %) live-born infants, 6633 (0·7 %) stillborn infants and 2135 (0·2 %) fetuses from terminated pregnancies due to fetal anomalies were registered in the MBRN. Among the live- and stillborn infants of women who used vitamin supplements compared with infants of non-users, the adjusted relative risk (aRR) was 0·94 (95 % CI 0·91, 0·98) for total birth defects (n 18 382). Supplement use was associated with reduced risk of abdominal wall defects (aRR 0·58; 95 % CI 0·42, 0·80, n 377), genital organ defects (aRR 0·81; 95 % CI 0·72, 0·91, n 2299) and limb defects (aRR 0·81; 95 % CI 0·74, 0·90, n 3409). Protective associations were also suggested for NTD, respiratory system defects and digestive system defects although CI included the null value of 1. During the full study period, statistically significant associations between supplement use and defects in the eye, ear-face-neck, heart or oral clefts were not observed.

Authors+Show Affiliations

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Department of Dermatology, Haukeland University Hospital, Bergen, Norway.Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Cancer Registry of Norway, Oslo, Norway.Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32238218

Citation

Gildestad, Trude, et al. "Maternal Use of Folic Acid and Multivitamin Supplements and Infant Risk of Birth Defects in Norway, 1999-2013." The British Journal of Nutrition, vol. 124, no. 3, 2020, pp. 316-329.
Gildestad T, Bjørge T, Haaland ØA, et al. Maternal use of folic acid and multivitamin supplements and infant risk of birth defects in Norway, 1999-2013. Br J Nutr. 2020;124(3):316-329.
Gildestad, T., Bjørge, T., Haaland, Ø. A., Klungsøyr, K., Vollset, S. E., & Øyen, N. (2020). Maternal use of folic acid and multivitamin supplements and infant risk of birth defects in Norway, 1999-2013. The British Journal of Nutrition, 124(3), 316-329. https://doi.org/10.1017/S0007114520001178
Gildestad T, et al. Maternal Use of Folic Acid and Multivitamin Supplements and Infant Risk of Birth Defects in Norway, 1999-2013. Br J Nutr. 2020 08 14;124(3):316-329. PubMed PMID: 32238218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal use of folic acid and multivitamin supplements and infant risk of birth defects in Norway, 1999-2013. AU - Gildestad,Trude, AU - Bjørge,Tone, AU - Haaland,Øystein A, AU - Klungsøyr,Kari, AU - Vollset,Stein E, AU - Øyen,Nina, Y1 - 2020/04/02/ PY - 2020/4/3/pubmed PY - 2020/11/5/medline PY - 2020/4/3/entrez KW - Birth defects KW - Epidemiology KW - Folic acid KW - Multivitamins KW - Public health SP - 316 EP - 329 JF - The British journal of nutrition JO - Br J Nutr VL - 124 IS - 3 N2 - The association between folic acid supplementation and birth defects other than neural tube defects (NTD) remains unclear. We used a log-binomial regression model to investigate if periconceptional folic acid and/or multivitamin use was associated with birth defects in Norway with prospectively collected data from the Medical Birth Registry of Norway (MBRN) during 1999-2013. We used the European Surveillance of Congenital Anomalies (EUROCAT) classification system to define eleven organ-specific major birth defect groups (nervous system, eye, ear-face-neck, cardiovascular system, respiratory system, oral clefts, digestive system, abdominal wall, urinary system, genital organs and limb), with additional subgroups. Fetuses or infants whose mothers used folic acid and/or multivitamin supplements before and during pregnancy were classified as exposed. During the years 1999-2013, 888 294 (99·0 %) live-born infants, 6633 (0·7 %) stillborn infants and 2135 (0·2 %) fetuses from terminated pregnancies due to fetal anomalies were registered in the MBRN. Among the live- and stillborn infants of women who used vitamin supplements compared with infants of non-users, the adjusted relative risk (aRR) was 0·94 (95 % CI 0·91, 0·98) for total birth defects (n 18 382). Supplement use was associated with reduced risk of abdominal wall defects (aRR 0·58; 95 % CI 0·42, 0·80, n 377), genital organ defects (aRR 0·81; 95 % CI 0·72, 0·91, n 2299) and limb defects (aRR 0·81; 95 % CI 0·74, 0·90, n 3409). Protective associations were also suggested for NTD, respiratory system defects and digestive system defects although CI included the null value of 1. During the full study period, statistically significant associations between supplement use and defects in the eye, ear-face-neck, heart or oral clefts were not observed. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/32238218/Maternal_use_of_folic_acid_and_multivitamin_supplements_and_infant_risk_of_birth_defects_in_Norway_1999_2013_ L2 - https://www.cambridge.org/core/product/identifier/S0007114520001178/type/journal_article DB - PRIME DP - Unbound Medicine ER -