Written by Chrystal Moulton, Science Writer. Lack of supplementation was associated with a significantly increased risk a fetal heart defect compared to those who began taking supplements before pregnancy (OR = 4.19, P = 0.0117).
Various environmental and genetic factors contribute to the development of fetal heart defects1-3. Thus, understanding all the risk factors that contribute to congenital heart defects is important to developing preventative measures. In the current trial, researchers analyzed the relationship between folic acid intake before and during pregnancy and the occurrence of fetal heart defects4.
Pregnant women referred to medical centers between February 2021 and January 2022 for fetal heart diagnostics over the age of 18 years old were recruited for this analysis. A total of 660 women were examined and 200 were included in this analysis. Researchers used a food frequency questionnaire to assess dietary intake of folic acid before and during pregnancy. Dietary consumption was verified through a one day in person interview. Researchers used information from the food frequency questionnaires to assess whether or not each participant met nutritional requirements for folate intake. Food frequency questionnaires were conducted on the day of the fetal echocardiographic examination. On that day also, participants completed questionnaires on general health and social demographic information was gathered. Of the 200 women included in this analysis, 79 women had children born with a heart defect and 121 bore children without heart defects or other developmental defects. The women who gave birth to children with congenital heart defects were categorized into one group [Group A]; while those who gave birth to children without defects constituted Group B. Logistical regression analysis was used to assess the relationship between folate intake and the risk of congenital heart defects in the fetus.
Researchers observed no statistically significant difference in age and diet between those who bore children with congenital heart defects and those without. Researchers however did observe a significant difference in the age of the fetus between both groups (P = 0.0004). Women in both groups consumed less than the recommended amount of folate [600mcg]. And although there was a trend associated between the risk of fetal heart defects and low dietary intake of folic acid, that association did not reach statistical significance (OR = 1.48, P> 0.05). Further analysis showed that lack of supplementation was associated with a significantly increased risk a fetal heart defect compared to those who began taking supplements before pregnancy (OR = 4.19, P = 0.0117). Women who began supplementation after week 8 of pregnancy had an increased risk of fetal heart defects, however it was much lower than not supplementing at all (OR = 2.90, P = 0.0474). This demonstrated that the timing of folic acid supplementation was also important in preventing fetal heart defects. No statistical significance was observed between alcohol consumption, parental education, mother’s place of residence, BMI, medications containing heparin, iodine, insulin, as well as other medicines, or cigarette smoking and the risk of congenital heart defects in the fetus. Diabetes, thyroid diseases, and hypertension before or during pregnancy had no statistically significant impact on the risk of fetal heart defects. Researchers did observe however, the occurrence of fetal heart defects was statistically and significantly dependent on the presence of congenital heart defects in the mother, father, or sibling (OR = 3.27, P = 0.0294). Researchers also noticed that the use of lutein (OR = 0.33, P = 0.0397) and Duphaston (OR = 0.31, P = 0.0206) during pregnancy was associated with a reduced risk of congenital heart defects in the fetus. No significant association was observed between the dose of folic acid and the time of supplementation in each group.
Data from this research supports existing evidence citing the importance of folic acid supplementation as a protective measure against congenital heart defects in newborns. Additional research will be needed to assess supplemental dose that provides optimal prevention of fetal heart defects.
Source: Kolmaga, Agnieszka, Elżbieta Trafalska, Ewelina Gaszyńska, Julia Murlewska, Sławomir Witkowski, Oskar Sylwestrzak, Łukasz Sokołowski, Maria Respondek-Liberska, and Iwona Strzelecka. “Folic Acid and Selected Risk Factors for Fetal Heart Defects—Preliminary Study Results.” Nutrients 16, no. 17 (2024): 3024.
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/license
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Posted November 12, 2024.
Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.
References:
- Wondemagegn AT, Afework M. The association between folic acid supplementation and congenital heart defects: Systematic review and meta-analysis. SAGE Open Med. 2022;10:20503121221081069. doi:10.1177/20503121221081069
- Dolk H, McCullough N, Callaghan S, et al. Risk factors for congenital heart disease: The Baby Hearts Study, a population-based case-control study. PLoS One. 2020;15(2):e0227908. doi:10.1371/journal.pone.0227908
- Liu H, Ou J, Chen Y, et al. Association of Maternal Folate Intake and Offspring MTHFD1 and MTHFD2 Genes with Congenital Heart Disease. Nutrients. Aug 9 2023;15(16)doi:10.3390/nu15163502
- Kolmaga A, Trafalska E, Gaszyńska E, et al. Folic Acid and Selected Risk Factors for Fetal Heart Defects-Preliminary Study Results. Nutrients. Sep 6 2024;16(17)doi:10.3390/nu16173024
