Lack of periconceptional vitamins or supplements that contain folic acid and diabetes mellitus–associated birth defects

• Published in: American journal of obstetrics and gynecology 2012-03, Vol.206 (3), p.218.e1-218.e13
• Main Authors: Correa, Adolfo, MD, PhD, Gilboa, Suzanne M., PhD, Botto, Lorenzo D., MD, Moore, Cynthia A., MD, PhD, Hobbs, Charlotte A., MD, PhD, Cleves, Mario A., PhD, Riehle-Colarusso, Tiffany J., MD, Waller, D. Kim, PhD, Reece, E. Albert, MD, PhD, MBA
• Format: Article
• Language: English
• Subjects: Anencephaly - drug therapy; Anencephaly - epidemiology; Anencephaly - prevention & control; Biological and medical sciences; birth defect; Case-Control Studies; Congenital Abnormalities - drug therapy; Congenital Abnormalities - epidemiology; Congenital Abnormalities - prevention & control; diabetes mellitus; Diabetes Mellitus - drug therapy; Diabetes Mellitus - epidemiology; Diabetes. Impaired glucose tolerance; Dietary Supplements; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; folic acid; Folic Acid - therapeutic use; Gynecology. Andrology. Obstetrics; Humans; Infant; Medical sciences; Obstetrics and Gynecology; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications - prevention & control; Pregnancy in Diabetics - drug therapy; Pregnancy in Diabetics - epidemiology; supplement; vitamin
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.12.018

Objective The purpose of this study was to examine the risk of birth defects in relation to diabetes mellitus and the lack of use of periconceptional vitamins or supplements that contain folic acid. Study Design The National Birth Defects Prevention Study (1997-2004) is a multicenter, population-based case-control study of birth defects (14,721 cases and 5437 control infants). Cases were categorized into 18 types of heart defects and 26 noncardiac birth defects. We estimated odds ratios for independent and joint effects of preexisting diabetes mellitus and a lack of periconceptional use of vitamins or supplements that contain folic acid. Results The pattern of odds ratios suggested an increased risk of defects that are associated with diabetes mellitus in the absence vs the presence of the periconceptional use of vitamins or supplements that contain folic acid. Conclusion The lack of periconceptional use of vitamins or supplements that contain folic acid may be associated with an excess risk for birth defects due to diabetes mellitus.