Mother's Healthy Diet (not just Folic Acid) Reduces Birth Defects

1 post / 0 new
Mother's Healthy Diet (not just Folic Acid) Reduces Birth Defects


Carmichael SL, Yang W, Feldkamp ML, et al. Reduced risks of neural tube defects and orofacial clefts with higher diet quality. Arch Pediatr Adolesc Med 2011; DOI: 10.1001/archpediatrics.2011.185.
DOI: 10.1001/archpediatrics.2011.185
related editorial:
Jacobs DR, Mursu J, Meyer KA. The importance of food. Arch Pediatr Adolesc Med 2011; DOI: 10.1001/archpediatrics.2011.184. (Editorial)

Online First: October 3, 2011

Reduced Risks of Neural Tube Defects and Orofacial Clefts With Higher Diet Quality
Suzan L. Carmichael, PhD; Wei Yang, MD, MS, MA; Marcia Lynn Feldkamp, PhD, PA, MSPH; Ronald G. Munger, PhD; Anna Maria Siega-Riz, PhD; Lorenzo D. Botto, MD; Gary Shaw, DrPH; for the National Birth Defects Prevention Study
Arch Pediatr Adolesc Med. Published online October 3, 2011. doi:10.1001/archpediatrics.2011.185
Objective  To examine whether better maternal diet quality was associated with reduced risk for selected birth defects.
Design  A multicenter, population-based case-control study, the National Birth Defects Prevention Study.
Setting  Ten participating centers in the United States.
Participants  Eligible subjects' estimated due dates were from October 1997 through December 2005. Telephone interviews were conducted with 72% of case and 67% of control mothers. Analyses included 936 cases with neural tube defects (NTDs), 2475 with orofacial clefts, and 6147 nonmalformed controls.
Main Exposures  Food-frequency data were used to calculate the Mediterranean Diet Score (MDS) and Diet Quality Index (DQI), modeled after existing indices.
Main Outcome Measure  Adjusted odds ratios (ORs).
Results  After covariate adjustment, increasing diet quality based on either index was associated with reduced risks for the birth defects studied. The strongest association was between anencephaly and DQI; the OR for highest vs lowest quartile was 0.49 (95% CI, 0.31-0.75). The ORs for cleft lip with or without cleft palate and cleft palate and DQI were also notable (0.66 [95% CI, 0.54-0.81] and 0.74 [95%CI, 0.56-0.96], respectively).
Conclusions  Healthier maternal dietary patterns, as measured by diet quality scores, were associated with reduced risks of NTDs and clefts. These results suggest that dietary approaches could lead to further reduction in risks of major birth defects and complement existing efforts to fortify foods and encourage periconceptional multivitamin use.

Author Affiliations: Department of Pediatrics, Stanford University, Stanford, California (Drs Carmichael, Yang, and Shaw); Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City (Drs Feldkamp and Botto); Utah Birth Defect Network, Utah Department of Health, Salt Lake City (Dr Feldkamp); Department of Nutrition, Utah State University, Logan (Dr Munger); and Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (Dr Siega-Riz).
Group Information: A list of the National Birth Defects Prevention Study Investigators appears at

© 2011 American Medical Association.