Do multivitamin or folic acid supplements reduce the risk for congenital heart defects? Evidence and gaps

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Public Health

Background:

• Congenital heart defects (CHDs) are common birth anomalies and a leading cause of infant mortality.
• Effective primary prevention strategies for most CHDs are currently lacking.
• Emerging evidence suggests a potential link between prenatal supplement use and reduced CHD risk.

Purpose of the Study:

• To review and synthesize existing evidence on the association between multivitamin use and CHD risk.
• To discuss the implications of current findings for public health.
• To propose a framework for future research in this area.

Main Methods:

• Literature review of observational studies and clinical trials.
• Analysis of epidemiological data on supplement use and CHD incidence.
• Synthesis of evidence regarding the timing and dosage of multivitamins.

Main Results:

• Several studies indicate a reduced risk of CHDs in offspring whose mothers used multivitamins around conception and in early pregnancy.
• The protective effect appears strongest with periconceptional folic acid supplementation.
• Variability in study designs and populations necessitates cautious interpretation.

Conclusions:

• Multivitamin supplementation may represent a feasible primary prevention strategy for a subset of CHDs.
• Further well-designed prospective studies are required to establish causality and optimal supplementation protocols.
• Public health initiatives should consider promoting periconceptional multivitamin use.