Document Detail

Multivitamin supplementation and risk of birth defects.
MedLine Citation:
PMID:  10512421     Owner:  NLM     Status:  MEDLINE    
It is widely accepted that supplementation with folic acid, a B vitamin, reduces the risk of neural tube defects (NTDs). This case-control study tested the hypothesis that multivitamins reduce risks of selected birth defects other than NTDs. Infants with and without birth defects and aborted fetuses with birth defects were ascertained in the greater metropolitan areas of Boston, Philadelphia, and Toronto during 1993-1996. Mothers were interviewed within 6 months after delivery about a variety of factors, including details on vitamin use. Eight case groups were included: cleft lip with or without cleft palate, cleft palate only, conotruncal defects, ventricular septal defects, urinary tract defects, limb reduction defects, congenital hydrocephaly, and pyloric stenosis (n's ranged from 31 to 186). Controls were 521 infants without birth defects (nonmalformed controls) and 442 infants with defects other than those of the cases (malformed controls). Daily multivitamin supplementation was evaluated according to gestational timing categories, including periconceptional use (28 days before through 28 days after the last menstrual period). Odds ratios (ORs) below 1.0 were observed for all case groups except cardiac defects, regardless of control type. For periconceptional use, ORs with 95% confidence intervals that excluded 1.0 were estimated for limb reduction defects using both nonmalformed controls (OR = 0.3) and malformed controls (OR = 0.2) and for urinary tract defects using both nonmalformed controls (OR = 0.6) and malformed controls (OR = 0.5). Statistically significant ORs for use that began after the periconceptional period were observed for cleft palate only and urinary tract defects. These data support the hypothesis that periconceptional vitamin supplementation may extend benefits beyond a reduction in NTD risk. However, other than folic acid's protecting against NTDs, it is not clear what nutrient or combination of nutrients might affect risk of other specific defects.
M M Werler; C Hayes; C Louik; S Shapiro; A A Mitchell
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of epidemiology     Volume:  150     ISSN:  0002-9262     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-19     Completed Date:  1999-10-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  675-82     Citation Subset:  IM    
Slone Epidemiology Unit, School of Public Health, Boston University, MA, USA.
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MeSH Terms
Boston / epidemiology
Case-Control Studies
Confidence Intervals
Congenital Abnormalities / epidemiology*,  prevention & control*
Dietary Supplements / statistics & numerical data*
Infant, Newborn
Odds Ratio
Ontario / epidemiology
Philadelphia / epidemiology
Risk Factors
Vitamins / administration & dosage*
Grant Support
Reg. No./Substance:

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