European Journal of Nutrition

, Volume 47, Issue 7, pp 357–365

Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects

  • Huberdina P. M. Smedts
  • Maryam Rakhshandehroo
  • Anna C. Verkleij-Hagoort
  • Jeanne H. M. de Vries
  • Jaap Ottenkamp
  • Eric A. P. Steegers
  • Régine P. M. Steegers-Theunissen
ORIGINAL CONTRIBUTION

DOI: 10.1007/s00394-008-0735-6

Cite this article as:
Smedts, H.P.M., Rakhshandehroo, M., Verkleij-Hagoort, A.C. et al. Eur J Nutr (2008) 47: 357. doi:10.1007/s00394-008-0735-6

Abstract

Background

With the exception of studies on folic acid, little evidence is available concerning other nutrients in the pathogenesis of congenital heart defects (CHDs). Fatty acids play a central role in embryonic development, and the B-vitamins riboflavin and nicotinamide are co-enzymes in lipid metabolism.

Aim of the study

To investigate associations between the maternal dietary intake of fats, riboflavin and nicotinamide, and CHD risk in the offspring.

Methods

A case-control family study was conducted in 276 mothers of a child with a CHD comprising of 190 outflow tract defects (OTD) and 86 non-outflow tract defects (non-OTD) and 324 control mothers of a non-malformed child. Mothers filled out general and food frequency questionnaires at 16 months after the index-pregnancy, as a proxy of the habitual food intake in the preconception period. Nutrient intakes (medians) were compared between cases and controls by Mann–Whitney U test. Odds ratios (OR) for the association between CHDs and nutrient intakes were estimated in a logistic regression model.

Results

Case mothers, in particular mothers of a child with OTD, had higher dietary intakes of saturated fat, 30.9 vs. 29.8 g/d; < 0.05. Dietary intakes of riboflavin and nicotinamide were lower in mothers of a child with an OTD than in controls (1.32 vs. 1.41 mg/d; < 0.05 and 14.6 vs. 15.1 mg/d; < 0.05, respectively). Energy, unsaturated fat, cholesterol and folate intakes were comparable between the groups. Low dietary intakes of both riboflavin (<1.20 mg/d) and nicotinamide (<13.5 mg/d) increased more than two-fold the risk of a child with an OTD, especially in mothers who did not use vitamin supplements in the periconceptional period (OR 2.4, 95%CI 1.4–4.0). Increasing intakes of nicotinamide (OR 0.8, 95%CI 0.7–1.001, per unit standard deviation increase) decreased CHD risk independent of dietary folate intake.

Conclusions

A maternal diet high in saturated fats and low in riboflavin and nicotinamide seems to contribute to CHD risk, in particular OTDs.

Keywords

congenital heart anomalysaturated fatB-vitaminsrisk factorsprevention

Copyright information

© Spinger 2008

Authors and Affiliations

  • Huberdina P. M. Smedts
    • 1
  • Maryam Rakhshandehroo
    • 1
    • 2
  • Anna C. Verkleij-Hagoort
    • 1
  • Jeanne H. M. de Vries
    • 2
  • Jaap Ottenkamp
    • 3
  • Eric A. P. Steegers
    • 1
  • Régine P. M. Steegers-Theunissen
    • 1
    • 4
    • 5
    • 6
  1. 1.Obstetrics and Gynaecology, Division of Obstetrics and Prenatal MedicineErasmus MC, University Medical CentreRotterdamThe Netherlands
  2. 2.Human NutritionWageningen UniversityWageningenThe Netherlands
  3. 3.Paediatric Cardiology, CAHAL-centre for congenital anomalies of the heart, Amsterdam/LeidenLeiden University Medical CentreLeidenThe Netherlands
  4. 4.EpidemiologyErasmus MC, University Medical CentreRotterdamThe Netherlands
  5. 5.Clinical GeneticsErasmus MC, University Medical CentreRotterdamThe Netherlands
  6. 6.Paediatrics/Division of Pediatric CardiologyErasmus MC–Sophia Children’s Hospital, University Medical CentreRotterdamThe Netherlands