High Maternal Vitamin E Intake by Diet or Supplements Is Associated With Congenital Heart Defects in the Offspring

Abstract

Previous studies have suggested that either low or high maternal dietary intake of various oxidants and/or antioxidants may produce congenital heart defects (CHDs) and other malformations among preterm infants. In one prior study, high maternal intake of supplements containing vitamin A and retinol, its biologically active form, were associated with CHDs. The present case-control study evaluated the effect of both inadequate and high maternal dietary and supplement intake of vitamin E and retinol on the occurrence of CHDs in Dutch infants. The investigators analyzed data for a case group consisting of 276 mothers of children with CHD and a control group consisting of 324 mothers of children without CHD. At 16 months postpartum, the case and control group mothers completed food frequency questionnaires covering dietary intake of vitamin E for the previous month. Mothers also provided information on intake of supplements containing vitamin E during the periconceptional period, defined as 4 weeks before conception until 8 weeks after conception. The Mann–Whitney U test was used to compare data for the case and control groups. A multivariable logistic regression model determined risk estimates for possible association between dietary intake of vitamin E and retinol, and CHD. Dietary vitamin E intake was 13.3 mg/day (range 8.1–20.4 mg/day) in the case group compared to 12.6 mg/day (range 8.5–19.8 mg/day) in the control group (P = 0.05). A significant trend was found for a higher risk of CHD with increased dietary intake of vitamin E (P-trend = 0.008). High intake of dietary vitamin E as well as vitamin E supplements was associated with a five- to nine-fold increase in the risk of CHD; the OR for those who took a total of more than12.6 mg/day was 9.1 (95% CI: 2.0–41.4), and was 4.8 (1.1–20.2) for those who took more than 14.9 mg/day. No significant association was observed between maternal dietary retinol intake and CHD risk. These findings suggest that high intake of vitamin E during the periconceptional period and pregnancy may increase the risk of CHD. Users of a vitamin E supplement may be at highest risk.