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PEDIATRICS Vol. 111 No. 5 May 2003, pp. 1146-1151

Do Multivitamin Supplements Attenuate the Risk for Diabetes-Associated Birth Defects?

Adolfo Correa, MD, PhD, Lorenzo Botto, MD, Yecai Liu, MS, Joseph Mulinare, MD, MSPH and J. David Erickson, DDS, PhD

From the Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia

--> Objective. To evaluate whether the risk for birth defects associated with maternal diabetes is attenuated by use of multivitamin supplements during the periconceptional period.

Methods. In the population-based Atlanta Birth Defects Case-Control Study, we identified case infants who had nonsyndromic birth defects that were reported to be associated with diabetes (n = 3278) and were born during 1968–1980 to residents of metropolitan Atlanta. Controls were infants without birth defects (n = 3029). Maternal diabetes was defined as reported diabetes with onset before the date of birth of the index infant, and periconceptional use of multivitamins was defined as reported regular use of multivitamin supplements from 3 months before pregnancy through the first 3 months of pregnancy.

Results. Offspring of mothers with diabetes had an increased risk for selected birth defects. However, the increased risk was limited to offspring of mothers who had diabetes and had not taken multivitamins during the periconceptional period (odds ratio: 3.93; 95% confidence interval: 1.79–8.63). Offspring of mothers who had diabetes and had taken multivitamins during the periconceptional period had no increased risk for birth defects (odds ratio: 0.15; 95% confidence interval: 0.00–1.99).

Conclusions. Periconceptional use of multivitamin supplements may reduce the risk for birth defects among offspring of mothers with diabetes.

Key Words: birth defects • congenital heart defects • central nervous system defects • diabetes • multivitamin supplements • prevention

Abbreviations: OR, odds ratio • CI, confidence interval

Received for publication Oct 2, 2002; Accepted Dec 4, 2002.


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eLetters:

Read all eLetters

MV vs folic acid supplementation
John A. Cranton
Pediatrics Online, 27 May 2003 [Full text]
No attenuation on the risk for diabetes-associated birth defects by folic acid fortification
Eduardo E Castilla, et al.
Pediatrics Online, 2 Dec 2003 [Full text]
Re: No attenuation on the risk for diabetes-associated birth defects by folic acid fortification
Adolfo Correa, et al.
Pediatrics Online, 29 Dec 2003 [Full text]