Maternal Folic Acid Supplementation and Congenital Heart Defects in Down Syndrome Open Access

Evans, Alexander (2017)

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Background: Maternal folic acid supplementation may be associated with a decreased risk for some congenital heart defects. Individuals with Down syndrome have an increased risk for congenital heart defects and preliminary evidence suggests a potential mechanism for folic acid.

Methods: Mothers of a child with Down syndrome (proband) participating in the National Down Syndrome Project and Emory Down Syndrome Study reported periconceptual exposures, including use of prenatal vitamin and supplements containing folic acid. Logistic regression was used on this data to assess the relationship between maternal folic acid exposure and specific congenital heart defects while controlling for maternal race/ethnicity, proband sex, maternal use of alcohol and cigarettes, gestational diabetes, and maternal age at birth of proband.

Results: Folic acid supplementation was less frequent among probands with complete atrioventricular septal defects (OR = 0.68; p = 0.0195), atrial septal defects (OR = 0.64; p = 0.0431) and both atrial septal and ventricular septal defects (OR = 0.50; p = 0.0179) compared to probands with no heart defect. There was no statistically significant association with folic acid and partial atrioventricular septal defects (OR = 0.89.; p = 0.3711) or ventricular septal defects (OR = 0.69; p = 0.0652), although the similar reduction in use was estimated.

Conclusions: Our findings suggest an association of periconceptual maternal folic acid exposure and certain congenital heart defects in infants with Down syndrome.

Table of Contents

Background ...1

Methods .......2

Results ........5

Discussion ....10

References ...16

Tables ..........18

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