Maternal Dietary Glycemic Intake and the Risk of Neural Tube Defects

摘要

Both maternal diabetes and obesity have been associated with an increased risk of neural tube defects (NTD),npossibly due to a sustained state of hyperglycemia and/or hyperinsulinemia. Data were collected in the BostonnUniversity Slone Birth Defects Study (a case-control study) from 1988 to 1998. The authors examined whether highndietary glycemic index (DGI) and high dietary glycemic load (DGL) increased the risk of NTDs in nondiabeticnwomen. Mothers of NTD cases and nonmalformed controls were interviewed in person within 6 months afterndelivery about diet and other exposures. Odds ratios and 95% confidence intervals were estimated from logisticnregression for high DGI (u000160) and high DGL (u0001205), with cutpoints determined by cubic spline. Of 698 casenmothers, 25% had high DGI and 4% had high DGL. Of 696 control mothers, 15% had high DGI and 2% had highnDGL. After adjustment for sociodemographic factors and other dietary factors, the odds ratio for high DGI was 1.5n(95% confidence interval: 1.1, 2.0); for high DGL, it was 1.8 (95% confidence interval: 0.8, 4.0). Diets with proportionallynhigh DGI or DGL may put the developing fetus at risk of an NTD, adding further evidence that hyperglycemianlies within the pathogenic pathway.