Maternal use of nutritional supplements during the first month of pregnancy and decreased risk of Down's syndrome: Case-control study

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Abstract

Objective: We studied the association between the use of nutritional supplements during the first gestational month and the origin of Down's syndrome. Methods: We compared 781 subjects with Down's syndrome caused by pure trisomy 21 with their matched controls who had no defect. We also compared subjects who had Down's syndrome with groups of 22 843 patient controls (i.e., subjects with other congenital abnormalities) and 38 151 population controls (without defects). Subjects with Down's syndrome and other congenital abnormalities were identified in the large population-based dataset of the Hungarian Congenital Abnormality Registry between 1980 and 1996, and matched population controls were selected from the National Birth Registry. There were three sources of exposure data: 1) prospective and medically recorded data based on prenatal logbooks, 2) retrospective maternal information based on questionnaires, and 3) home visits in non-respondent cases of Down's syndrome and congenital abnormalities. A possible association between the use of nutritional supplements, mainly folic acid and antioxidant vitamins C and E, during the first month of pregnancy and the incidence of Down's syndrome was studied. Results: A significant protective effect was seen with large doses of folic acid (∼6 mg/d) and iron (150-300 mg/d of ferrous sulfate) during the first gestational month against Down's syndrome (adjusted odds ratio 0.4, 95% confidence interval 0.2 to 0.7 for both). In general, folic acid and iron were used together, so it was difficult to separate these effects due to the limited number of subjects and controls. Only iron alone showed a protective effect against Down's syndrome (odds ratio 0.4, 95% confidence interval 0.1 to 0.9). The use of antioxidant vitamins was a rare event in the first month of pregnancy. Conclusion: Pharmacologic doses of folic acid and iron appear to have a preventive effect against Down's syndrome.

Original languageEnglish
Pages (from-to)698-704
Number of pages7
JournalNutrition
Volume21
Issue number6
DOIs
Publication statusPublished - Jun 2005

Fingerprint

Down Syndrome
Case-Control Studies
Mothers
Pregnancy
Folic Acid
Iron
ferrous sulfate
Population Control
Registries
Antioxidants
Odds Ratio
Confidence Intervals
House Calls
Information Storage and Retrieval
Vitamin E
Vitamins
Ascorbic Acid
Parturition
Incidence

Keywords

  • Antioxidants
  • Case-control study
  • Down's syndrome
  • Folic acid
  • Iron
  • Methylenetetrahydrofolate-reductase gene mutations
  • Mitochondrial gene mutations

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Surgery
  • Medicine (miscellaneous)

Cite this

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title = "Maternal use of nutritional supplements during the first month of pregnancy and decreased risk of Down's syndrome: Case-control study",
abstract = "Objective: We studied the association between the use of nutritional supplements during the first gestational month and the origin of Down's syndrome. Methods: We compared 781 subjects with Down's syndrome caused by pure trisomy 21 with their matched controls who had no defect. We also compared subjects who had Down's syndrome with groups of 22 843 patient controls (i.e., subjects with other congenital abnormalities) and 38 151 population controls (without defects). Subjects with Down's syndrome and other congenital abnormalities were identified in the large population-based dataset of the Hungarian Congenital Abnormality Registry between 1980 and 1996, and matched population controls were selected from the National Birth Registry. There were three sources of exposure data: 1) prospective and medically recorded data based on prenatal logbooks, 2) retrospective maternal information based on questionnaires, and 3) home visits in non-respondent cases of Down's syndrome and congenital abnormalities. A possible association between the use of nutritional supplements, mainly folic acid and antioxidant vitamins C and E, during the first month of pregnancy and the incidence of Down's syndrome was studied. Results: A significant protective effect was seen with large doses of folic acid (∼6 mg/d) and iron (150-300 mg/d of ferrous sulfate) during the first gestational month against Down's syndrome (adjusted odds ratio 0.4, 95{\%} confidence interval 0.2 to 0.7 for both). In general, folic acid and iron were used together, so it was difficult to separate these effects due to the limited number of subjects and controls. Only iron alone showed a protective effect against Down's syndrome (odds ratio 0.4, 95{\%} confidence interval 0.1 to 0.9). The use of antioxidant vitamins was a rare event in the first month of pregnancy. Conclusion: Pharmacologic doses of folic acid and iron appear to have a preventive effect against Down's syndrome.",
keywords = "Antioxidants, Case-control study, Down's syndrome, Folic acid, Iron, Methylenetetrahydrofolate-reductase gene mutations, Mitochondrial gene mutations",
author = "E. Czeizel and E. Puh{\'o}",
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doi = "10.1016/j.nut.2004.10.017",
language = "English",
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pages = "698--704",
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T1 - Maternal use of nutritional supplements during the first month of pregnancy and decreased risk of Down's syndrome

T2 - Case-control study

AU - Czeizel, E.

AU - Puhó, E.

PY - 2005/6

Y1 - 2005/6

N2 - Objective: We studied the association between the use of nutritional supplements during the first gestational month and the origin of Down's syndrome. Methods: We compared 781 subjects with Down's syndrome caused by pure trisomy 21 with their matched controls who had no defect. We also compared subjects who had Down's syndrome with groups of 22 843 patient controls (i.e., subjects with other congenital abnormalities) and 38 151 population controls (without defects). Subjects with Down's syndrome and other congenital abnormalities were identified in the large population-based dataset of the Hungarian Congenital Abnormality Registry between 1980 and 1996, and matched population controls were selected from the National Birth Registry. There were three sources of exposure data: 1) prospective and medically recorded data based on prenatal logbooks, 2) retrospective maternal information based on questionnaires, and 3) home visits in non-respondent cases of Down's syndrome and congenital abnormalities. A possible association between the use of nutritional supplements, mainly folic acid and antioxidant vitamins C and E, during the first month of pregnancy and the incidence of Down's syndrome was studied. Results: A significant protective effect was seen with large doses of folic acid (∼6 mg/d) and iron (150-300 mg/d of ferrous sulfate) during the first gestational month against Down's syndrome (adjusted odds ratio 0.4, 95% confidence interval 0.2 to 0.7 for both). In general, folic acid and iron were used together, so it was difficult to separate these effects due to the limited number of subjects and controls. Only iron alone showed a protective effect against Down's syndrome (odds ratio 0.4, 95% confidence interval 0.1 to 0.9). The use of antioxidant vitamins was a rare event in the first month of pregnancy. Conclusion: Pharmacologic doses of folic acid and iron appear to have a preventive effect against Down's syndrome.

AB - Objective: We studied the association between the use of nutritional supplements during the first gestational month and the origin of Down's syndrome. Methods: We compared 781 subjects with Down's syndrome caused by pure trisomy 21 with their matched controls who had no defect. We also compared subjects who had Down's syndrome with groups of 22 843 patient controls (i.e., subjects with other congenital abnormalities) and 38 151 population controls (without defects). Subjects with Down's syndrome and other congenital abnormalities were identified in the large population-based dataset of the Hungarian Congenital Abnormality Registry between 1980 and 1996, and matched population controls were selected from the National Birth Registry. There were three sources of exposure data: 1) prospective and medically recorded data based on prenatal logbooks, 2) retrospective maternal information based on questionnaires, and 3) home visits in non-respondent cases of Down's syndrome and congenital abnormalities. A possible association between the use of nutritional supplements, mainly folic acid and antioxidant vitamins C and E, during the first month of pregnancy and the incidence of Down's syndrome was studied. Results: A significant protective effect was seen with large doses of folic acid (∼6 mg/d) and iron (150-300 mg/d of ferrous sulfate) during the first gestational month against Down's syndrome (adjusted odds ratio 0.4, 95% confidence interval 0.2 to 0.7 for both). In general, folic acid and iron were used together, so it was difficult to separate these effects due to the limited number of subjects and controls. Only iron alone showed a protective effect against Down's syndrome (odds ratio 0.4, 95% confidence interval 0.1 to 0.9). The use of antioxidant vitamins was a rare event in the first month of pregnancy. Conclusion: Pharmacologic doses of folic acid and iron appear to have a preventive effect against Down's syndrome.

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KW - Case-control study

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KW - Folic acid

KW - Iron

KW - Methylenetetrahydrofolate-reductase gene mutations

KW - Mitochondrial gene mutations

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