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Does periconceptional multivitamin use reduce the risk for limb deficiency in offspring?
Q Yang1, M J Khoury, R S Olney
1Epidemic Intelligence Service, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Insights
Periconceptional multivitamin use may reduce the risk of limb defects in babies. This protective effect was observed for transverse limb deficiency but not longitudinal deficiency, suggesting potential causal heterogeneity.
Area of Science:
- Reproductive Health
- Pediatric Health
- Epidemiology
Background:
- Periconceptional multivitamin intake is increasingly linked to preventing certain birth defects.
- Evidence suggests potential benefits beyond neural tube defect prevention.
Purpose of the Study:
- To investigate the association between periconceptional multivitamin use and limb deficiency occurrence.
- To explore potential differences in effect based on limb deficiency type.
Main Methods:
- A population-based case-control study using data from the Atlanta Birth Defects Case-Control Study.
- Examined multivitamin use in mothers of infants with nonsyndromic limb deficiency and controls.
Main Results:
- Mothers using multivitamins periconceptionally had a reduced risk of limb deficiency (OR=0.47).
- The protective effect was primarily for transverse limb deficiency (OR=0.30), not longitudinal deficiency (OR=1.03).
- A trend of decreasing risk for transverse limb deficiencies with earlier vitamin use was observed.
Conclusions:
- Periconceptional multivitamin use may lower the risk of specific limb deficiencies in offspring.
- Findings suggest potential causal heterogeneity among different types of limb deficiencies.
Abstract:
There is accumulating evidence that periconceptional multivitamin use may prevent the occurrence of some birth defects other than neural tube defects. Using data from the population-based Atlanta Birth Defects Case-Control Study, we investigated the possible association between periconceptional multivitamin use and the occurrence of limb deficiency. We examined the periconceptional use of multivitamins among mothers of 117 babies with nonsyndromic limb deficiency who were liveborn or stillborn to residents of metropolitan Atlanta from 1968 to 1980 and among mothers of 3,029 control babies born without birth defects who were randomly selected through birth certificates. We found that children whose mothers were periconceptional multivitamin users had a lower risk of having a limb deficiency [odds ratio (OR) = 0.47; 95% confidence interval (CI) = 0.23-0.97]. This protective effect, however, was mostly seen for transverse limb deficiency (OR = 0.30; 95% CI = 0.07-1.32) and not for longitudinal deficiency (including preaxial and postaxial deficiencies; OR = 1.03; 95% CI = 0.17-4.30). Adjustment for potential confounding factors did not change these findings. We found a trend of decreasing risk for all transverse limb deficiencies with earlier vitamin use. These data indicate that mothers' periconceptional multivitamin use may reduce the risk for some types of limb deficiency among their offspring. In addition, because we did not find the protective effect for all types of limb deficiency, the data may also indicate causal heterogeneity of limb deficiencies.