Abstract
The effects of zinc, copper, and selenium on human congenital heart defects (CHDs) remain unclear. This study aimed to investigate the associations of the maternal total, dietary, and supplemental intakes of zinc, copper, and selenium during pregnancy with CHDs. A hospital-based case-control study was performed, including 474 cases and 948 controls in Northwest China. Eligible participants waiting for delivery were interviewed to report their diets and characteristics in pregnancy. Mixed logistic regression was adopted to examine associations and interactions between maternal intakes and CHDs. Higher total intakes of zinc, selenium, zinc to copper ratio, and selenium to copper ratio during pregnancy were associated with lower risks of total CHDs and the subtypes, and the tests for trend were significant (all p < 0.05). The significantly inverse associations with CHDs were also observed for dietary intakes of zinc, selenium, zinc to copper ratio, selenium to copper ratio, and zinc and selenium supplements use during pregnancy and in the first trimester. Moreover, high zinc and high selenium, even with low or high copper, showed a significantly reduced risk of total CHDs. Efforts to promote zinc and selenium intakes during pregnancy need to be strengthened to reduce the incidence of CHDs in the Chinese population.
Highlights
Congenital heart defects (CHDs) are the most common birth defects in the world, with an estimated birth prevalence of 9.4‰ [1]
In the present case-control study, we observed that higher total intakes of zinc, selenium, zinc to copper ratio, and selenium to copper ratio during pregnancy were associated with reduced risks of total congenital heart defects (CHDs) and the subtypes
The significantly inverse associations with CHDs were observed for dietary intakes of zinc, selenium, zinc to copper ratio, and selenium to copper ratio during pregnancy, and maternal zinc and selenium supplements use during pregnancy and in the first trimester
Summary
Congenital heart defects (CHDs) are the most common birth defects in the world, with an estimated birth prevalence of 9.4‰ [1]. There is little evidence from human studies about the effects of zinc, copper, and selenium on CHDs [11–16], and the results were not consistent [11–16]. There was even one study reporting higher zinc levels in the CHDs cases than in the healthy controls [11]. Two studies showed a positive association between copper level and CHDs [13,15], while the other two studies reported no association [14,16]. One study found an inverse association between selenium level and CHDs [12], while another study showed a positive association [14]. It is warranted to further conduct studies among humans to elucidate the effects of zinc, copper, and selenium on CHDs
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