Evidence exists for an association between maternal use of a vitamin supplement with folic acid in early pregnancy and a reduced risk for offspring with conotruncal heart defects. Few inquiries about periconceptional nutrition, other than folate, and risk of heart defects have been made. Data derived from a population-based case-control study of fetuses and liveborn infants among a cohort of California births between July 1999 and June 2004. In total, 76% of eligible case mothers and 77% of eligible control mothers were interviewed. Cases included 140 with d-transposition of great arteries (dTGA), and 163 with tetralogy of Fallot (TOF). Total number of controls was 698. Self-reported use of vitamins was elicited by questionnaire for the periconceptional period, Dietary nutrient intake was elicited by a well-known food frequency questionnaire. The odds ratio for dTGA associated with supplemental vitamin use was 1.0 (95% confidence interval, 0.7-1.5) and for TOF was 0.9 (0.6-1.3). We observed increased risks associated with lower dietary intakes of linoleic acid, total carbohydrate, and fructose for dTGA, whereas decreased risks were observed for lower intakes of total protein and methionine for TOF. Lower dietary intake of several micronutrients, namely folate, niacin, riboflavin, and vitamins B12, A, and E, even after simultaneous adjustment for other studied nutrients, were associated with increased risks of dTGA, but not for TOF. These associations were observed among women who did not use vitamin supplements periconceptionally. Analytic consideration of several potential confounders did not reveal alternative interpretations of the results. Our population-based case-control study attempted to extend the knowledge base on nutrition and heart defect risk and prevention.
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