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Zhao X, Ma X, Song L, Sun J, Jiao X, Wang J, Mao B, Liu Q. Metal stannum exposure increases the risk of congenital heart defects occurence in offspring: A case-control study in Lanzhou. Int J Cardiol 2024; 411:132270. [PMID: 38880423 DOI: 10.1016/j.ijcard.2024.132270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND The purpose of this study was to analyse the association between stannum exposure during pregnancy and congenital heart diseases in offspring. METHODS Based on a prospective birth cohort study conducted in Gansu Maternal and Child Health Hospital from 2010 to 2012, 14,359 pregnant women were followed up using a nested case-control study method. 97 pregnant women whose offspring were diagnosed with CHDs were used as the case group, and 194 pregnant women whose offspring did not suffer from congenital heart diseases were used as the control group in a ratio of 1:2 according to their age and place of birth. Inductively coupled plasma mass spectrometry was used to determine elemental stannum in blood samples from pregnant women hospitalized for delivery and in fetal cord blood samples. Multifactorial logistic regression analysis was used to assess the association between stannum and offspring CHDs. RESULTS There was a moderate positive correlation between the concentration of stannum in pregnant women's blood and that in umbilical cord blood. A higher concentrations of maternal blood stannum level was associated with a greater risk of CHDs (aOR 3.409, 95%CI 1.785-6.826), isolated CHDs (aOR 4.044, 95%CI 1.803-9.070), multiple CHDs (aOR 2.625, 95%CI 1.137-6.061), patent ductus arteriosus (aOR 2.882, 95%CI 1.443-5.756), atrial septal defects (aOR 3.067, 95%CI 1.406-6.690), ventricular septal defects (aOR 7.414, 95%CI 1.414-38.874). There was a correlation between the maternal and cord blood sample suggesting stannum crosses the placenta.
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Affiliation(s)
- Xiaoli Zhao
- The first Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China; Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China
| | - Xuejing Ma
- The first Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China; Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China
| | - Lifang Song
- The first Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China; Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China
| | - Jianhao Sun
- Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China
| | - Xinjuan Jiao
- The first Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
| | - Jian Wang
- Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China
| | - Baohong Mao
- Department of Medical Education, Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China; School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China.
| | - Qing Liu
- The first Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China; Gansu Provincial Maternity and ChildCare Hospital, Lanzhou 730000, Gansu Province, China.
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Lin T, Jia H, Li Y, Xu Y, Zhao B, Zheng D, Yan H, Zhao M, Li Y, Xia L, Zhou F, Liu C, Ma K, Mi M, Gu J. Epidemiological Survey of Congenital Heart Disease Among Children Aged from 2 to 18 in Suo County, Nagqu, Tibet. High Alt Med Biol 2024; 25:129-135. [PMID: 38511279 DOI: 10.1089/ham.2023.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Lin, Tian, Huaping Jia, Yunming Li, Yongxing Xu, Bei Zhao, Dong Zheng, Hongfeng Yan, Meihui Zhao, Yanlei Li, Liping Xia, Fengxia Zhou, Cuiping Liu, Ke Ma, Ma Mi, and Jianwen Gu. Epidemiological survey of congenital heart disease among children aged from 2 to 18 in Suo County, Nagqu, Tibet. High Alt Med Biol. 00:000-000, 2024. Background: Studies have reported the prevalence of congenital heart disease (CHD) in parts of Tibet, but relative epidemiological surveys are rare. We aimed to explore the prevalence of CHD in children and its relationship with family history in Suo County, Nagqu, Tibet, an altitude of 3,980 meters. Methods: We recruited 4,002 children aged 2-18 years. Subjects underwent a family history investigation, cardiac auscultation, and clinical manifestation examination and then received echocardiographic screening. Results: The prevalence of CHD among children in Suo County was 0.97% (39 cases), much higher than the prevalence at sea level. The most common subtype was atrial septal defect, accounting for 53.9% of CHD, followed by patent ductus arteriosus (33.3%) and ventricular septal defect (12.8%). We also found that children whose mothers had previously borne children with CHD had a higher risk of CHD than those without (p = 0.002); other factors related to CHD during pregnancy, such as smoking, drinking, drug use, and viral infection, showed no statistical differences between children with and without CHD. Conclusions: The prevalence of CHD in children in Suo County is much higher than at low altitude, consisting mostly of simple forms with left-to-right shunt, with rare complex CHD. These results support implementing diagnostic and treatment plans to prevent CHD in Suo County.
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Affiliation(s)
- Tian Lin
- Department of Neurology, Strategic Support Force Medical Center, Beijing, China
| | - Huaping Jia
- Department of Ultrasound Diagnosis, Strategic Support Force Medical Center, Beijing, China
| | - Yunming Li
- Department of Information, Medical Support Center, The General Hospital of Western Theater Command, People's Liberation Army, Chengdu, Sichuan, China
| | - Yongxing Xu
- Department of Nephrology, Strategic Support Force Medical Center, Beijing, China
| | - Bei Zhao
- Department of Cardiology, Strategic Support Force Medical Center, Beijing, China
| | - Dong Zheng
- Department of Radiology, Strategic Support Force Medical Center, Beijing, China
| | - Hongfeng Yan
- Department of General Surgery, Strategic Support Force Medical Center, Beijing, China
| | - Meihui Zhao
- Department of Rehabilitation Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, General Hospital of People's Liberation Army, Beijing, China
| | - Yanlei Li
- Department of Pharmacy, Strategic Support Force Medical Center, Beijing, China
| | - Liping Xia
- Department of Ophthalmology, Strategic Support Force Medical Center, Beijing, China
| | - Fengxia Zhou
- Department of Ultrasound Diagnosis, Strategic Support Force Medical Center, Beijing, China
| | - Cuiping Liu
- Department of Respiratory Medicine, Strategic Support Force Medical Center, Beijing, China
| | - Ke Ma
- Department of General Medicine, People's Hospital of Suo County, Nagqu, Tibet, China
| | - Ma Mi
- Department of General Medicine, People's Hospital of Suo County, Nagqu, Tibet, China
| | - Jianwen Gu
- Department of Neurosurgery, Strategic Support Force Medical Center, Beijing, China
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Maddhesiya J, Mohapatra B. Understanding the Genetic and Non-genetic Interconnections in the Aetiology of Isolated Congenital Heart Disease: An Updated Review: Part 1. Curr Cardiol Rep 2024; 26:147-165. [PMID: 38546930 DOI: 10.1007/s11886-024-02022-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE OF REVIEW Congenital heart disease (CHD) is the most frequently occurring birth defect. Majority of the earlier reviews focussed on the association of genetic factors with CHD. A few epidemiological studies provide convincing evidence for environmental factors in the causation of CHD. Although the multifactorial theory of gene-environment interaction is the prevailing explanation, explicit understanding of the biological mechanism(s) involved, remains obscure. Nonetheless, integration of all the information into one platform would enable us to better understand the collective risk implicated in CHD development. RECENT FINDINGS Great strides in novel genomic technologies namely, massive parallel sequencing, whole exome sequencing, multiomics studies supported by system-biology have greatly improved our understanding of the aetiology of CHD. Molecular genetic studies reveal that cardiac specific gene variants in transcription factors or signalling molecules, or structural proteins could cause CHD. Additionally, non-hereditary contributors such as exposure to teratogens, maternal nutrition, parental age and lifestyle factors also contribute to induce CHD. Moreover, DNA methylation and non-coding RNA are also correlated with CHD. Here, we inform that a complex combination of genetic, environmental and epigenetic factors interact to interfere with morphogenetic processes of cardiac development leading to CHD. It is important, not only to identify individual genetic and non-inherited risk factors but also to recognize which factors interact mutually, causing cardiac defects.
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Affiliation(s)
- Jyoti Maddhesiya
- Cytogenetics Laboratory, Department of Zoology, Institute of Science, Banaras Hindu University, Uttar Pradesh, Varanasi, 221005, India
| | - Bhagyalaxmi Mohapatra
- Cytogenetics Laboratory, Department of Zoology, Institute of Science, Banaras Hindu University, Uttar Pradesh, Varanasi, 221005, India.
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Nakano H, Nakano A. The role of metabolism in cardiac development. Curr Top Dev Biol 2024; 156:201-243. [PMID: 38556424 DOI: 10.1016/bs.ctdb.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Metabolism is the fundamental process that sustains life. The heart, in particular, is an organ of high energy demand, and its energy substrates have been studied for more than a century. In recent years, there has been a growing interest in understanding the role of metabolism in the early differentiation of pluripotent stem cells and in cancer research. Studies have revealed that metabolic intermediates from glycolysis and the tricarboxylic acid cycle act as co-factors for intracellular signal transduction, playing crucial roles in regulating cell behaviors. Mitochondria, as the central hub of metabolism, are also under intensive investigation regarding the regulation of their dynamics. The metabolic environment of the fetus is intricately linked to the maternal metabolic status, and the impact of the mother's nutrition and metabolic health on fetal development is significant. For instance, it is well known that maternal diabetes increases the risk of cardiac and nervous system malformations in the fetus. Another notable example is the decrease in the risk of neural tube defects when pregnant women are supplemented with folic acid. These examples highlight the profound influence of the maternal metabolic environment on the fetal organ development program. Therefore, gaining insights into the metabolic environment within developing fetal organs is critical for deepening our understanding of normal organ development. This review aims to summarize recent findings that build upon the historical recognition of the environmental and metabolic factors involved in the developing embryo.
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Affiliation(s)
- Haruko Nakano
- Department of Molecular, Cell, and Developmental Biology, UCLA, Los Angeles, CA, United States
| | - Atsushi Nakano
- Department of Molecular, Cell, and Developmental Biology, UCLA, Los Angeles, CA, United States; Cardiology Division, Department of Medicine, UCLA, Los Angeles, CA, United States; Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, UCLA, Los Angeles, CA, United States; Molecular Biology Institute, UCLA, Los Angeles, CA, United States; Department of Cell Physiology, The Jikei University School of Medicine, Tokyo, Japan.
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Li J, Zhang C, Mao B, Liu Q, Wang Y, Yi B, Liu Q. Association between aluminum and iron exposure in maternal blood and umbilical cord blood and congenital heart defects in children. PeerJ 2024; 12:e16755. [PMID: 38274332 PMCID: PMC10809980 DOI: 10.7717/peerj.16755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
Background Congenital heart disease (CHDs) is the major cause of mortality from birth defects, affecting up to 1% of live births worldwide. However, the relationship between aluminum (Al) and iron (Fe) levels and the risk of CHDs has yielded inconsistent results. Methods We conducted a pair-matched case-control study that included 97 CHDs and 194 non-CHDs to investigate the association and interaction between Al/Fe exposure and the risk of CHDs in a birth cohort study in Lanzhou, China. Results Higher concentrations of cord blood Al were associated with a greater risk of total CHDs (aOR = 2.826, 95% CI [1.009-7.266]) and isolated CHDs (aOR = 10.713, 95% CI [1.017-112.851]) compared to the lowest Al level. Both in maternal blood and cord blood, a significant dose-effect was observed between Al level and total CHDs (Ptrend < 0.05), but a similar pattern was not observed for Fe. High Al in addition to high Fe appeared to elicit a stronger association with CHDs than both lowest tertile of Al and Fe level in umbilical cord blood, particularly for multiple CHDs, septal defects and patent ductus arteriosus. Conclusions Our study suggests that exposure to Al during pregnancy (≥2,408 μg/L) is significantly associated with an increased risk of CHDs in offspring, especially septal defects, and that high levels of Al and Fe are strongly correlated with fetal heart development. Further research is needed to understand the underlying mechanisms.
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Affiliation(s)
- Jing Li
- Department of Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
- Laboratory Medicine Center, Lanzhou University Second Hospital, Lanzhou, Gansu Provincial, China
| | - Chunhua Zhang
- Department of Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
| | - Baohong Mao
- Department of Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
| | - Qian Liu
- Department of Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
| | - Yanxia Wang
- Department of Scientific Research Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
| | - Bin Yi
- Department of Neonatology, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
| | - Qing Liu
- Department of Gynecology, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Provincial, China
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Ibrahim S, Gaborit B, Lenoir M, Collod-Beroud G, Stefanovic S. Maternal Pre-Existing Diabetes: A Non-Inherited Risk Factor for Congenital Cardiopathies. Int J Mol Sci 2023; 24:16258. [PMID: 38003449 PMCID: PMC10671602 DOI: 10.3390/ijms242216258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023] Open
Abstract
Congenital heart defects (CHDs) are the most common form of birth defects in humans. They occur in 9 out of 1000 live births and are defined as structural abnormalities of the heart. Understanding CHDs is difficult due to the heterogeneity of the disease and its multifactorial etiology. Advances in genomic sequencing have made it possible to identify the genetic factors involved in CHDs. However, genetic origins have only been found in a minority of CHD cases, suggesting the contribution of non-inherited (environmental) risk factors to the etiology of CHDs. Maternal pregestational diabetes is associated with a three- to five-fold increased risk of congenital cardiopathies, but the underlying molecular mechanisms are incompletely understood. According to current hypotheses, hyperglycemia is the main teratogenic agent in diabetic pregnancies. It is thought to induce cell damage, directly through genetic and epigenetic dysregulations and/or indirectly through production of reactive oxygen species (ROS). The purpose of this review is to summarize key findings on the molecular mechanisms altered in cardiac development during exposure to hyperglycemic conditions in utero. It also presents the various in vivo and in vitro techniques used to experimentally model pregestational diabetes. Finally, new approaches are suggested to broaden our understanding of the subject and develop new prevention strategies.
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Affiliation(s)
- Stéphanie Ibrahim
- Aix Marseille University, INSERM, INRAE, C2VN, 13005 Marseille, France;
| | - Bénédicte Gaborit
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, 13005 Marseille, France
| | - Marien Lenoir
- Department of Congenital Heart Surgery, La Timone Children Hospital, APHM, Aix Marseille University, 13005 Marseille, France
| | | | - Sonia Stefanovic
- Aix Marseille University, INSERM, INRAE, C2VN, 13005 Marseille, France;
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Chen L, Yang T, Wang T, Sun M, Qin J. Relationships between Maternal Folic Acid Supplementation and GATA4 Gene Polymorphisms in Patients with Non-Chromosomal Congenital Heart Disease: A Hospital-Based Case-Control Study in China. Nutrients 2023; 15:4478. [PMID: 37892553 PMCID: PMC10610291 DOI: 10.3390/nu15204478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to investigate the relationships between maternal FA supplementation and nine single-nucleotide variants of the GATA4 gene in non-chromosomal CHD and further explore the gene-environment interactions associated with CHD. A total of 585 CHD patients and 600 controls were recruited in the case-control study. Maternal FA (FA-containing multivitamin) supplementation information and nine polymorphisms of the GATA4 gene were collected in this study. Adjusted ORs (aOR) and their 95% confidence intervals (CIs) were calculated using proper statistical methods to analyze the relationships between the two main exposures of interest with respect to CHD. After adjusting the suspicious confounding factors, a significantly increased risk for CHD in offspring was found with non-FA supplementation before/during the pregnancy to CHD in offspring (aOR = 1.58, 95% CI: 1.01-2.48). We suggested taking FA supplementation before/during the pregnancy to prevent CHD in offspring, especially in the preconception period (aOR = 0.53, 95% CI: 0.32-0.90). The genetic results showed that the polymorphisms of rs4841588, rs12458, and rs904018 under specific genotypes and genetic models were significantly related to CHD. The gene-environment interaction between rs10108052 and FA supplementation before/during pregnancy could increase the risk of CHD (aOR = 5.38, 95% CI: 1.67-17.09, Pinteraction = 0.004). Relationships between maternal FA supplementation and specific polymorphisms of the GATA4 gene, as well as the gene-environment interaction, were significantly associated with CHD in offspring.
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Affiliation(s)
- Letao Chen
- Infection Control Center, Xiangya Hospital, Central South University, Changsha 410017, China;
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410017, China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China; (T.Y.); (M.S.)
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China; (T.Y.); (M.S.)
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China; (T.Y.); (M.S.)
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410017, China; (T.Y.); (M.S.)
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Kawai S, Pak K, Iwamoto S, Kawakami C, Inuzuka R, Maeda J, Furutani Y, Kamisago M, Takatsuki S, Uyeda T, Yamagishi H, Ito S, Kobayashi T. Association Between Maternal Factors in Early Pregnancy and Congenital Heart Defects in Offspring: The Japan Environment and Children's Study. J Am Heart Assoc 2023; 12:e029268. [PMID: 37642029 PMCID: PMC10547327 DOI: 10.1161/jaha.122.029268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
Background Many prenatal factors are reported to be associated with congenital heart defects (CHD) in offspring. However, these associations have not been adequately examined using large-scale birth cohorts. Methods and Results We evaluated a data set of the Japan Environmental and Children's Study. The primary outcome was a diagnosis of CHD by age 2 years. We defined the following variables as exposures: maternal baseline characteristics, fertilization treatment, maternal history of diseases, socioeconomic status, maternal alcohol intake, smoking, tea consumption, maternal dietary intake, and maternal medications and supplements up to 12 weeks of gestation. We used multivariable logistic regression analysis to assess the associations between various exposures and CHD in offspring. A total of 91 664 singletons were included, among which 1264 (1.38%) had CHD. In multivariable analysis, vitamin A supplements (adjusted odds ratio [aOR], 5.78 [95% CI, 2.30-14.51]), maternal use of valproic acid (aOR, 4.86 [95% CI, 1.51-15.64]), maternal use of antihypertensive agents (aOR, 3.80 [95% CI, 1.74-8.29]), maternal age ≥40 years (aOR, 1.59 [95% CI, 1.14-2.20]), and high maternal hemoglobin concentration in the second trimester (aOR, 1.10 per g/dL [95% CI, 1.03-1.17]) were associated with CHD in offspring. Conclusions Using a Japanese large-scale birth cohort study, we found 6 maternal factors to be associated with CHD in offspring.
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Affiliation(s)
- Shun Kawai
- Department of PediatricsYokohama City UniversityYokohamaJapan
| | - Kyongsun Pak
- Biostatistics Unit, Department of Data ScienceNational Center for Child Health and DevelopmentTokyoJapan
| | - Shintaro Iwamoto
- Biostatistics Unit, Department of Data ScienceNational Center for Child Health and DevelopmentTokyoJapan
| | | | - Ryo Inuzuka
- Department of PediatricsThe University of Tokyo HospitalTokyoJapan
| | - Jun Maeda
- Department of CardiologyTokyo Metropolitan Children’s Medical CenterTokyoJapan
| | - Yoshiyuki Furutani
- Department of Pediatric Cardiology and Adult Congenital CardiologyTokyo Women’s Medical UniversityTokyoJapan
| | - Mitsuhiro Kamisago
- Department of PediatricsNippon Medical School Tama Nagayama HospitalTokyoJapan
| | | | - Tomomi Uyeda
- Department of Pediatric CardiologySakakibara Heart InstituteTokyoJapan
| | | | - Shuichi Ito
- Department of PediatricsYokohama City UniversityYokohamaJapan
| | - Tohru Kobayashi
- Department of Data ScienceNational Center for Child Health and DevelopmentTokyoJapan
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Huang L, Mao B, Li J, Nan N, He L, Qiu J, Yi B, Liu Q. Associations Between the Lead Level in Maternal Blood and Umbilical Cord Blood and Congenital Heart Diseases in Offspring. Biol Trace Elem Res 2023; 201:2191-2199. [PMID: 35794301 DOI: 10.1007/s12011-022-03338-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/16/2022] [Indexed: 11/02/2022]
Abstract
The incidence of congenital heart diseases (CHDs) shows an increasing trend and results in large health burdens in China. However, there have been inconsistent results of the relationship between lead (Pb) level and risk of CHDs. We performed a pair-matched case-control study and included 97 cases and 194 controls to investigate the association between pregnancy Pb exposure and the risk of CHDs in a birth cohort study conducted in Lanzhou, China. The results showed that compared to the lowest Pb tertile, both highest tertile levels of maternal blood and umbilical cord blood Pb were associated with an increased risk of CHDs. The similar significant results were found in cases with isolated CHDs. Compared to both lowest tertiles of Pb level in maternal blood and umbilical cord blood, the highest tertile was associated with an increased risk of CHDs, especially for isolated CHDs. Overall, our study suggests a significant association between pregnancy Pb exposure and risk of CHDs, especially for isolated CHDs. Future studies are needed to elucidate the underlying mechanism.
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Affiliation(s)
- Lei Huang
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Jiayue Li
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Nan Nan
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Li He
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Bin Yi
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China.
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China.
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Liu C, Wang D, Jin L, Zhang J, Meng W, Jin L, Shang X. The relationship between maternal periconceptional micronutrient supplementation and non-syndromic cleft lip/palate in offspring. Birth Defects Res 2023; 115:545-554. [PMID: 36595654 DOI: 10.1002/bdr2.2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aimed to explore the relationship between maternal periconceptional supplementation with folic acid only (FAO) or with multiple micronutrients containing folic acid (MMFA) and non-syndromic cleft lip/palate in offspring. METHOD The data came from a prenatal health care system and a birth defects surveillance system in Beijing, China, from 2013 to 2018. Information on maternal FAO/MMFA supplementation was collected by questionnaire in the first trimester, and data on cleft lip/palate were collected at delivery or termination of pregnancy. Inverse probability weighting (IPW) by the propensity score to adjust for the confounders and Poisson regression model was used to estimate risk ratios (RRs) and their 95% confidence intervals (CIs). RESULTS A total of 63,969 participants were included in the study. Compared to the no-supplementation group, the adjusted RR for the supplementation group was 0.51 (95% CI: 0.40, 0.64). And the adjusted RRs for FAO and MMFA compared to the no-supplementation group were 0.56 (95% CI: 0.40, 0.76) and 0.48 (95% CI: 0.35, 0.65), respectively. Compared to supplement FAO and MMFA with less than 8 days out of 10 days, the adjusted RRs for FAO and MMFA with 8 or more days out of 10 days were 1.17 (95% CI: 0.78, 1.75), and 2.05 (95% CI: 1.37, 3.31), respectively. CONCLUSION Maternal supplementation with micronutrients, either FAO or MMFA, during the periconceptional period can reduce the risk for non-syndromic cleft lip/palate in offspring. However, women should be more cautious with MMFA supplementation.
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Affiliation(s)
- Chunyi Liu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Di Wang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Jie Zhang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.,Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, China
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Epigenetic Evaluation of the TBX20 Gene and Environmental Risk Factors in Mexican Paediatric Patients with Congenital Septal Defects. Cells 2023; 12:cells12040586. [PMID: 36831251 PMCID: PMC9953838 DOI: 10.3390/cells12040586] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/25/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
The TBX20 gene has a key role during cardiogenesis, and it has been related to epigenetic mechanisms in congenital heart disease (CHD). The purpose of this study was to assess the association between DNA methylation status and congenital septal defects. The DNA methylation of seven CpG sites in the TBX20 gene promoter was analyzed through pyrosequencing as a quantitative method in 48 patients with congenital septal defects and 104 individuals with patent ductus arteriosus (PDA). The average methylation was higher in patients than in PDA (p < 0.001). High methylation levels were associated with a higher risk of congenital septal defects (OR = 4.59, 95% CI = 1.57-13.44, p = 0.005). The ROC curve analysis indicated that methylation of the TBX20 gene could be considered a risk marker for congenital septal defects (AUC = 0.682; 95% CI = 0.58-0.77; p < 0.001). The analysis of environmental risk factors in patients with septal defects and PDA showed an association between the consumption of vitamins (OR = 0.10; 95% CI = 0.01-0.98; p = 0.048) and maternal infections (OR = 3.10; 95% CI = 1.26-7.60; p = 0.013). These results suggest that differences in DNA methylation of the TBX20 gene can be associated with septal defects.
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12
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Xiao D, Li W, Zhang WH, Wen Z, Mo W, Lu C, Guo L, Yang L. Maternal periconceptional environmental exposure and offspring with congenital heart disease: a case-control study in Guangzhou, China. BMC Pregnancy Childbirth 2023; 23:57. [PMID: 36694158 PMCID: PMC9872400 DOI: 10.1186/s12884-023-05355-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Congenital heart defects (CHDs) are a major global health problem, yet their crucial environmental risk factors are still unclear. We aimed to explore the associations between maternal periconceptional environmental exposures and all CHDs, isolated and multiple CHDs and CHDs subtypes. METHOD A case-control study including 675 infants with CHDs and 1545 healthy controls was conducted. Participating mothers who delivered in Guangzhou from October 2019 to November 2021 were recruited. To examine the independent associations between maternal periconceptional environmental exposure and offspring with CHDs, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression model. RESULTS Maternal exposure to living near main roads [adjusted OR (aOR) = 1.94, 95% CI = 1.06-3.56] and housing renovation (aOR = 1.94, 95% CI = 1.03-3.67) during the periconceptional period were positively related to a greater risk of all CHDs, similar results were also found in isolated CHDs rather than multiple CHDs. Additionally, living near main roads was positively associated with secundum atrial septal defect/patent foramen ovale (aOR = 2.65, 95% CI = 1.03-6.81) and housing renovation was strongly positively associated with ventricular septal defect (aOR = 5.08, 95% CI = 2.05-12.60). However, no association was observed between incense burning and family relationships and all CHDs, isolated and multiple CHDs and CHDs subtypes. CONCLUSION Living near main roads and housing renovation during the periconceptional period are significantly associated with the increased risks for all CHDs and isolated CHDs. Further study is needed to extend sample size to explore the effects of time and frequency of burning incense and family relationships on CHDs in offspring.
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Affiliation(s)
- Di Xiao
- grid.413428.80000 0004 1757 8466Department of Comprehensive Maternal and Child Health, Guangzhou Women and Children’s Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623 China
| | - Weidong Li
- grid.413428.80000 0004 1757 8466Department of Comprehensive Maternal and Child Health, Guangzhou Women and Children’s Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623 China
| | - Wei-Hong Zhang
- grid.5342.00000 0001 2069 7798International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium ,grid.4989.c0000 0001 2348 0746School of Public Health, Université libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
| | - Zihao Wen
- grid.413428.80000 0004 1757 8466Department of Comprehensive Maternal and Child Health, Guangzhou Women and Children’s Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623 China
| | - Weijian Mo
- grid.413428.80000 0004 1757 8466Department of Comprehensive Maternal and Child Health, Guangzhou Women and Children’s Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623 China
| | - Ciyong Lu
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Lan Guo
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Li Yang
- grid.413428.80000 0004 1757 8466Department of Comprehensive Maternal and Child Health, Guangzhou Women and Children’s Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623 China
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13
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Naz N, Moshkdanian G, Miyan S, Eljabri S, James C, Miyan J. A Paternal Methylation Error in the Congenital Hydrocephalic Texas (H-Tx) Rat Is Partially Rescued with Natural Folate Supplements. Int J Mol Sci 2023; 24:1638. [PMID: 36675153 PMCID: PMC9860872 DOI: 10.3390/ijms24021638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
Folate deficiencies, folate imbalance and associated abnormal methylation are associated with birth defects, developmental delays, neurological conditions and diseases. In the hydrocephalic Texas (H-Tx) rat, 10-formyl tetrahydrofolate dehydrogenase (FDH) is reduced or absent from the CSF and the nuclei of cells in the brain and liver and this is correlated with decreased DNA methylation. In the present study, we tested whether impaired folate metabolism or methylation exists in sexually mature, unaffected H-Tx rats, which may explain the propagation of hydrocephalus in their offspring. We compared normal Sprague Dawley (SD, n = 6) rats with untreated H-Tx (uH-Tx, n = 6 and folate-treated H-Tx (TrH-Tx, n = 4). Structural abnormalities were observed in the testis of uH-Tx rats, with decreased methylation, increased demethylation, and cell death, particularly of sperm. FDH and FRα protein expression was increased in uH-Tx males but not in folate-treated males but tissue folate levels were unchanged. 5-Methylcytosine was significantly reduced in untreated and partially restored in treated individuals, while 5-hydroxymethylcytosine was not significantly changed. Similarly, a decrease in DNA-methyltransferase-1 expression in uH-Tx rats was partially reversed with treatment. The data expose a significant germline methylation error in unaffected adult male H-Tx rats from which hydrocephalic offspring are obtained. Reduced methylation in the testis and sperm was partially recovered by treatment with folate supplements leading us to conclude that this neurological disorder may not be completely eradicated by maternal supplementation alone.
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Affiliation(s)
| | | | | | | | | | - Jaleel Miyan
- Division of Neuroscience, Faculty of Biology, Medicine and Health, The University of Manchester, 3.540 Stopford Building, Oxford Road, Manchester M13 9PT, UK
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14
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Lian Z, Wu Z, Gu R, Wang Y, Wu C, Cheng Z, He M, Wang Y, Cheng Y, Gu HF. Evaluation of Cardiovascular Toxicity of Folic Acid and 6S-5-Methyltetrahydrofolate-Calcium in Early Embryonic Development. Cells 2022; 11:cells11243946. [PMID: 36552710 PMCID: PMC9777352 DOI: 10.3390/cells11243946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Folic acid (FA) is a synthetic and highly stable version of folate, while 6S-5-methyltetrahydrofolate is the predominant form of dietary folate in circulation and is used as a crystalline form of calcium salt (MTHF-Ca). The current study aims to evaluate the toxicity and safety of FA and MTHF-Ca on embryonic development, with a focus on cardiovascular defects. We began to analyze the toxicity of FA and MTHF-Ca in zebrafish from four to seventy-two hours postfertilization and assessed the efficacy of FA and MTHF-Ca in a zebrafish angiogenesis model. We then analyzed the differently expressed genes in in vitro fertilized murine blastocysts cultured with FA and MTHF-Ca. By using gene-expression profiling, we identified a novel gene in mice that encodes an essential eukaryotic translation initiation factor (Eif1ad7). We further applied the morpholino-mediated gene-knockdown approach to explore whether the FA inhibition of this gene (eif1axb in zebrafish) caused cardiac development disorders, which we confirmed with qRT-PCR. We found that FA, but not MTHF-Ca, could inhibit angiogenesis in zebrafish and result in abnormal cardiovascular development, leading to embryonic death owing to the downregulation of eif1axb. MTHF-Ca, however, had no such cardiotoxicity, unlike FA. The current study thereby provides experimental evidence that FA, rather than MTHF-Ca, has cardiovascular toxicity in early embryonic development and suggests that excessive supplementation of FA in perinatal women may be related to the potential risk of cardiovascular disorders, such as congenital heart disease.
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Affiliation(s)
- Zenglin Lian
- Institute of Biological Chinese Medicine, Beijing Yichuang Institute of Biotechnology Industry, Beijing 100023, China
| | - Zhuanbin Wu
- Shanghai Model Organisms Center, Inc., Shanghai 201203, China
| | - Rui Gu
- Institute of Biological Chinese Medicine, Beijing Yichuang Institute of Biotechnology Industry, Beijing 100023, China
| | - Yurong Wang
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Chenhua Wu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 211198, China
| | - Zhengpei Cheng
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Mingfang He
- College of Biotechnology and Pharmaceutical Engineering, Nanjing Tech University, Nanjing 211816, China
| | - Yanli Wang
- National Health Commission Key Laboratory of Birth Defect Prevention, Henan Institute of Reproductive Health Science and Technology, Zhengzhou 450002, China
| | - Yongzhi Cheng
- College of Biotechnology and Pharmaceutical Engineering, Nanjing Tech University, Nanjing 211816, China
- Correspondence: (Y.C.); (H.F.G.)
| | - Harvest F. Gu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
- Correspondence: (Y.C.); (H.F.G.)
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15
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Zhang J, Zeng C, Huang X, Liao Q, Chen H, Liu F, Sun D, Luo S, Xiao Y, Xu W, Zeng D, Song M, Tian F. Association of homocysteine and polymorphism of methylenetetrahydrofolate reductase with early-onset post stroke depression. Front Nutr 2022; 9:1078281. [PMID: 36562046 PMCID: PMC9763289 DOI: 10.3389/fnut.2022.1078281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Background Homocysteine (Hcy) has been indicated to be involved in pathophysiology of post stroke depression (PSD). There is a lack of research to study the relationship between Hcy metabolism genes and PSD. Our study aims to investigate the relationship among Hcy metabolism genes, Hcy, and early-onset PSD. Materials and methods We recruited 212 patients with stroke and collected their peripheral blood sample, clinical data, and laboratory test on admission. 12 single nucleotide polymorphisms (SNPs) in methylenetetrahydrofolate reductase (MTHFR), methionine synthase reductase (MTRR), and methionine synthase (MTR) genes were genotyped by high-resolution melt analysis. PSD was diagnosed by DSM-V at 2 weeks after stroke. Binary logistic regression and haplotype analysis were used to examine the association between Hcy metabolism genes and PSD. Mediation analysis was performed to clarify whether the SNPs exerted their effect on PSD by affecting the Hcy level. Results 81 patients were diagnosed with PSD, and the incidence rate was 38.2%. Hcy level in PSD group was significantly higher than it in non-PSD group (p = 0.019). MTHFR rs1801133 AA genotype an A allele were associated with an elevated risk of PSD after adjustment for some confounding factors (OR = 4.021, 95% CI: 1.459∼11.080, p = 0.007 for AA genotype; OR = 1.808, 95% CI: 1.172∼2.788, p = 0.007 for A allele). Furthermore, the effect of MTHFR rs1801133 AA genotype on PSD was mediated by Hcy (OR = 1.569, 95% CI: 0.013∼3.350, p < 0.05). Conclusion MTHFR rs1801133 and Hcy were associated with PSD, and MTHFR rs1801133 may exert an effect on PSD via mediating Hcy level. This offers a new perspective for treating PSD and understanding the mechanism of PSD.
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Affiliation(s)
- Jingyuan Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Chang Zeng
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xia Huang
- Department of Critical Care Medicine, The First People’s Hospital of Huaihua, Huaihua, China
| | - Qiao Liao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hengshu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fan Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Dongren Sun
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Shihang Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yeqing Xiao
- Department of Neurology, Hengyang Central Hospital, Hengyang, China
| | - Weiye Xu
- Department of Human Anatomy and Neurobiology, School of Basic Medicine, Central South University, Changsha, China
| | - Danfeng Zeng
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, China
| | - Mingyu Song
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China,Mingyu Song,
| | - Fafa Tian
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Fafa Tian,
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16
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The Association of Folic Acid, Iron Nutrition during Pregnancy and Congenital Heart Disease in Northwestern China: A Matched Case-Control Study. Nutrients 2022; 14:nu14214541. [PMID: 36364804 PMCID: PMC9657607 DOI: 10.3390/nu14214541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background: The purpose of this study was to investigate the relationship between folic acid and iron nutrition during pregnancy and congenital heart disease (CHD) in the offspring. Methods: Conditional logistic regression models and nonlinear mixed-effects models were used to analyze the effects of folic acid and iron nutrition during pregnancy on CHD in offspring. Results: After adjusting for confounders, folic acid or iron supplementation during pregnancy reduced the risk for fetal CHD (OR = 0.60 (0.45, 0.82) or 0.36 (0.27, 0.48)). Similarly, dietary iron intake during pregnancy (≥29 mg/d) was associated with a reduced risk of fetal CHD (OR = 0.64 (0.46, 0.88)). Additionally, compared with women who only supplemented folic acid (OR = 0.59 (0.41, 0.84)) or iron (OR = 0.32 (0.16, 0.60)), women who supplemented both folic acid and iron had lower risk for newborns with CHD (OR = 0.22 (0.15, 0.34)). Similarly, compared with women who only supplemented folic acid (OR = 0.59 (0.41, 0.84)) or higher dietary iron intake (≥29 mg/d) (OR = 0.60 (0.33, 1.09)), women who supplemented both folic acid and higher dietary iron intake (≥29 mg/d) had lower risk for the newborn with CHD (OR = 0.41 (0.28, 0.62)). The combined effects were significant in the multiplication model (OR = 0.35 (0.26, 0.48) or 0.66 (0.50, 0.85)) but not in the additive model. Conclusions: Our study found that folic acid and iron nutrition during pregnancy were associated with a reduced risk of CHD in the offspring and confirmed a statistically significant multiplicative interaction between folic acid and iron nutrition on the reduced risk of CHD in offspring.
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17
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Sun J, Mao B, Wu Z, Jiao X, Wang Y, Lu Y, Ma X, Liu X, Xu X, Cui H, Lin X, Yi B, Qiu J, Liu Q. Relationship between maternal exposure to heavy metal titanium and offspring congenital heart defects in Lanzhou, China: A nested case-control study. Front Public Health 2022; 10:946439. [PMID: 35991008 PMCID: PMC9381958 DOI: 10.3389/fpubh.2022.946439] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies have found that exposure to heavy metals increased the incidence of congenital heart defects (CHDs). However, there is a paucity of information about the connection between exposure to titanium and CHDs. This study sought to examine the relationship between prenatal titanium exposure and the risk of CHDs in offspring. Methods We looked back on a birth cohort study that was carried out in our hospital between 2010 and 2012. The associations between titanium exposure and the risk of CHDs were analyzed by using logistic regression analysis to investigate titanium concentrations in maternal whole blood and fetal umbilical cord blood. Results A total of 97 case groups and 194 control groups were included for a nested case-control study. The [P50 (P25, P75)] of titanium were 371.91 (188.85, 659.15) μg/L and 370.43 (264.86, 459.76) μg/L in serum titanium levels in pregnant women and in umbilical cord serum titanium content in the CHDs group, respectively. There was a moderate positive correlation between the concentration of titanium in pregnant women's blood and that in umbilical cord blood. A higher concentrations of maternal blood titanium level was associated with a greater risk of CHDs (OR 2.706, 95% CI 1.547–4.734), the multiple CHDs (OR 2.382, 95% CI 1.219–4.655), atrial septal defects (OR 2.367, 95% CI 1.215–4.609), and patent ductus arteriosus (OR 2.412, 95% CI 1.336–4.357). Dramatically higher concentrations of umbilical cord blood levels had an increased risk of CHDs and different heart defects. Conclusion Titanium can cross the placental barrier and the occurrence of CHDs may be related to titanium exposure.
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Affiliation(s)
- Jianhao Sun
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
- The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China
| | - Baohong Mao
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Zhenzhen Wu
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Xinjuan Jiao
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yanxia Wang
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Yongli Lu
- The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China
| | - Xuejing Ma
- The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China
| | - Xiaohui Liu
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Hongmei Cui
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Xiaojuan Lin
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Bin Yi
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Qing Liu
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
- The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China
- *Correspondence: Qing Liu
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18
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Yang L, Wang W, Mao B, Qiu J, Guo H, Yi B, He X, Lin X, Lv L, Xu X, Liu Q, Cao Y, Chen Y. Maternal Folic Acid Supplementation, Dietary Folate Intake, and Low Birth Weight: A Birth Cohort Study. Front Public Health 2022; 10:844150. [PMID: 35757618 PMCID: PMC9218084 DOI: 10.3389/fpubh.2022.844150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/08/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives To investigate the independent and collective effects of maternal folic acid supplementation or dietary folate intake on the risk of low birth weight (LBW), and to further comprehensively examine the joint associations of folic acid supplementation and dietary folate intake with LBW by various clinical subtypes. Design Participants were recruited from Gansu Provincial Maternity and Child Care Hospital. A standardized and structured questionnaire was distributed to collect demographic factors, reproductive and medical history, occupational and residential history, physical activity, and diet. Data on pregnancy-related complications and birth outcomes were extracted from medical records. Unconditional logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for single and joint associations of folic acid supplementation and dietary folate intake with LBW. Setting A birth cohort data analysis using the 2010–2012 Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China. Participants In total, 9,231 pregnant women and their children were enrolled in the study. Results Compared with non-users, folic acid supplementation was associated with a reduced risk of LBW (OR: 0.80, 95% CI: 0.66–0.97), and the reduced risk was mainly seen for term-LBW (OR: 0.59, 95% CI: 0.41–0.85), and multiparous-LBW (OR: 0.72, 95% CI: 0.54–0.94). There were no significant associations between dietary folate intake and LBW, and there was no interaction between folic acid supplement and dietary folate intake on LBW. Conclusions Our study results indicated that folic acid supplementation was associated with a reduced risk of LBW, and there was no interaction between folic acid supplements and dietary folate intake on LBW.
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Affiliation(s)
- Liping Yang
- Department of Public Health and Infection Management, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, China
| | - Wenjuan Wang
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Baohong Mao
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Jie Qiu
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Huaqi Guo
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Yi
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaochun He
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaojuan Lin
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Ling Lv
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaoying Xu
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Qing Liu
- Department of Information Administration, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Yongchun Cao
- Department of Operation Management, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Yiming Chen
- Department of Human Resource, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
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Iacobazzi D, Alvino VV, Caputo M, Madeddu P. Accelerated Cardiac Aging in Patients With Congenital Heart Disease. Front Cardiovasc Med 2022; 9:892861. [PMID: 35694664 PMCID: PMC9177956 DOI: 10.3389/fcvm.2022.892861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/11/2022] [Indexed: 01/03/2023] Open
Abstract
An increasing number of patients with congenital heart disease (CHD) survive into adulthood but develop long-term complications including heart failure (HF). Cellular senescence, classically defined as stable cell cycle arrest, is implicated in biological processes such as embryogenesis, wound healing, and aging. Senescent cells have a complex senescence-associated secretory phenotype (SASP), involving a range of pro-inflammatory factors with important paracrine and autocrine effects on cell and tissue biology. While senescence has been mainly considered as a cause of diseases in the adulthood, it may be also implicated in some of the poor outcomes seen in patients with complex CHD. We propose that patients with CHD suffer from multiple repeated stress from an early stage of the life, which wear out homeostatic mechanisms and cause premature cardiac aging, with this term referring to the time-related irreversible deterioration of the organ physiological functions and integrity. In this review article, we gathered evidence from the literature indicating that growing up with CHD leads to abnormal inflammatory response, loss of proteostasis, and precocious age in cardiac cells. Novel research on this topic may inspire new therapies preventing HF in adult CHD patients.
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Affiliation(s)
| | | | | | - Paolo Madeddu
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
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20
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Zhang X, Liu L, Chen W, Wang F, Cheng Y, Liu Y, Lai Y, Zhang R, Qiao Y, Yuan Y, Lin Y, Xu W, Cao J, Gui Y, Zhao J. Gestational Leucylation Suppresses Embryonic T-Box Transcription Factor 5 Signal and Causes Congenital Heart Disease. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2201034. [PMID: 35320615 PMCID: PMC9130917 DOI: 10.1002/advs.202201034] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Indexed: 06/01/2023]
Abstract
Dysregulated maternal nutrition, such as vitamin deficiencies and excessive levels of glucose and fatty acids, increases the risk for congenital heart disease (CHD) in the offspring. However, the association between maternal amino-acid levels and CHD is unclear. Here, it is shown that increased leucine levels in maternal plasma during the first trimester are associated with elevated CHD risk in the offspring. High levels of maternal leucine increase embryonic lysine-leucylation (K-Leu), which is catalyzed by leucyl-tRNA synthetase (LARS). LARS preferentially binds to and catalyzes K-Leu modification of lysine 339 within T-box transcription factor TBX5, whereas SIRT3 removes K-Leu from TBX5. Reversible leucylation retains TBX5 in the cytoplasm and inhibits its transcriptional activity. Increasing embryonic K-Leu levels in high-leucine-diet fed or Sirt3 knockout mice causes CHD in the offspring. Targeting K-Leu using the leucine analogue leucinol can inhibit LARS activity, reverse TBX5 K-Leu modification, and decrease the occurrence of CHD in high-leucine-diet fed mice. This study reveals that increased maternal leucine levels increases CHD risk in the offspring through inhibition of embryonic TBX5 signaling, indicating that leucylation exerts teratogenic effects during heart development and may be an intervening target of CHD.
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Affiliation(s)
- Xuan Zhang
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Lian Liu
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Wei‐Cheng Chen
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Feng Wang
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Yi‐Rong Cheng
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Yi‐Meng Liu
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Yang‐Fan Lai
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Rui‐Jia Zhang
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Ya‐Nan Qiao
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Yi‐Yuan Yuan
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Yan Lin
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
- Key Laboratory of Reproduction Regulation of NPFPC and Institutes of Biomedical SciencesFudan UniversityShanghai200438P. R. China
| | - Wei Xu
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
- Key Laboratory of Reproduction Regulation of NPFPC and Institutes of Biomedical SciencesFudan UniversityShanghai200438P. R. China
| | - Jing Cao
- School of Basic Medical SciencesZhengzhou UniversityZhengzhou450001China
| | - Yong‐Hao Gui
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
| | - Jian‐Yuan Zhao
- Children's Hospital of Fudan UniversityObstetrics & Gynecology Hospital of Fudan UniversityFudan University Shanghai Cancer CenterState Key Laboratory of Genetic Engineeringand School of Life SciencesShanghai200438P. R. China
- School of Basic Medical SciencesZhengzhou UniversityZhengzhou450001China
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21
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Cheng Z, Gu R, Lian Z, Gu HF. Evaluation of the association between maternal folic acid supplementation and the risk of congenital heart disease: a systematic review and meta-analysis. Nutr J 2022; 21:20. [PMID: 35346212 PMCID: PMC8962131 DOI: 10.1186/s12937-022-00772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Folic acid (FA), as a synthetic form of folate, has been widely used for dietary supplementation in pregnant women. The preventive effect of FA supplementation on the occurrence and recurrence of fetal neural tube defects (NTD) has been confirmed. Incidence of congenital heart diseases (CHD), however, has been parallelly increasing worldwide. The present study aimed to evaluate whether FA supplementation is associated with a decreased risk of CHD. Methods We searched the literature using PubMed, Web of Science and Google Scholar, for the peer-reviewed studies which reported CHD and FA and followed with a meta-analysis. The study-specific relative risks were used as summary statistics for the association between maternal FA supplementation and CHD risk. Cochran's Q and I2 statistics were used to test for the heterogeneity. Results Maternal FA supplementation was found to be associated with a decreased risk of CHD (OR = 0.82, 95% CI: 0.72–0.94). However, the heterogeneity of the association was high (P < 0.001, I2 = 92.7%). FA supplementation within 1 month before and after pregnancy correlated positively with CHD (OR 1.10, 95%CI 0.99–1.23), and high-dose FA intake is positively associated with atrial septal defect (OR 1.23, 95%CI 0.64–2.34). Pregnant women with irrational FA use may be at increased risk for CHD. Conclusions Data from the present study indicate that the heterogeneity of the association between maternal FA supplementation and CHD is high and suggest that the real relationship between maternal FA supplementation and CHD may need to be further investigated with well-designed clinical studies and biological experiments. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00772-2.
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Affiliation(s)
- Zhengpei Cheng
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.,Strathclyde Institute of Pharmacology and Biomedical Science, University of Strathclyde, 16 Richmond St Glasgow, Glasgow, G1 1XQ, Scotland
| | - Rui Gu
- College of Biotechnology and Pharmaceutical Engineering, Nanjing Tech University, Nanjing, China
| | - Zenglin Lian
- Institute of Biological Chinese Medicine, Beijing Yichuang Institute of Biotechnology Industry, Beijing, China
| | - Harvest F Gu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.
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22
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Song X, Wei J, Shu J, Liu Y, Sun M, Zhu P, Qin J. Association of polymorphisms of FOLR1 gene and FOLR2 gene and maternal folic acid supplementation with risk of ventricular septal defect: a case-control study. Eur J Clin Nutr 2022; 76:1273-1280. [PMID: 35273364 DOI: 10.1038/s41430-022-01110-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES It was the first time to examine the role of maternal polymorphisms of FOLR1 gene and FOLR2 gene, as well as their interactions with maternal folic acid supplementation (FAS), in the risk of ventricular septal defect (VSD). METHODS A case-control study was conducted with 385 mothers of VSD infants and 652 controls. The exposures of interest were FAS and FOLR1 gene and FOLR2 gene polymorphisms. The logistic regression model was used for accessing the strength of association. RESULTS After controlling for the potential confounders, women who did not utilize folic acid had a substantially higher risk of VSD (aOR = 2.25; 95% CI: 1.48 to 3.43), compared to those who did. We also observed genetic polymorphisms of FOLR1 gene at rs2071010 (GA vs. GG: aOR = 0.63, 95%CI: 0.45 to 0.88) and rs11235462 (AA vs. TT: aOR = 0.53, 95%CI: 0.33 to 0.84), as well as FOLR2 gene at rs651646 (AA vs. TT: aOR = 0.46, 95%CI: 0.30 to 0.70), rs2298444 (CC vs. TT: aOR = 0.58, 95%CI: 0.36 to 0.91) and rs514933 (TC vs. TT: aOR = 0.57, 95%CI: 0.41 to 0.78) were associated with a lower risk of VSD. Furthermore, there was a statistically significant interaction between maternal FAS and genetic polymorphisms at rs514933 on the risk of VSD (FDR_P = 0.015). CONCLUSIONS The maternal genetic polymorphisms of the FOLR1 gene and FOLR2 gene, as well as FAS and their interactions, were shown to be significantly associated with the risk of VSD in offspring.
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Affiliation(s)
- Xinli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jing Shu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China. .,Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China. .,NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China. .,Hunan Provincial Key Laboratory of clinical epidemiology, Changsha, Hunan, China.
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23
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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. [PMID: 35284077 PMCID: PMC8905196 DOI: 10.1177/20503121221081069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/31/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction: Various trial and epidemiological studies consistently documented the association between maternal folic acid supplementations and neural tube defects. However, existing literatures revealed inconclusive findings about maternal periconceptional folic acid supplementations and the risk of congenital heart defects. Thus, the current systematic review and meta-analysis was aimed to estimate the pooled association between maternal periconceptional folic acid supplementations and congenital heart defects. Methods: Electronic searches of PubMed, Web of Science/Scopus, Cochrane library and Google Scholar databases were conducted to access the required studies published up to March 2021. Predetermined eligibility criteria were used for study selections. Data extraction were independently done on excel. STATA version 14 software was used to calculate the pooled effect size with 95% confidence intervals (95% CI) of maternal periconceptional folic acid supplementations on congenital heart defects using the DerSimonian and Laird random effects meta-analysis (random effects model). Statistical heterogeneity was checked using the Cochran Q test (chi-squared statistic), I2 statistic, and by visual inspection of the funnel plot. Results: A total of 37 studies of case–control, cohort and randomized controlled trial in nature were included in the review. The finding of the present systematic review and meta-analysis indicated that periconceptional folic acid supplementation significantly decreases the risk of congenital heart defects (risk ratio (RR), 0.79; CI, 0.71, 0.89). Both Cochrane Q test statistic (χ2 = 19.33, p = 0.962) and I2 test statistic (I2 = 0.0%, p = 0.962) did not reveal statistically significant heterogeneity among included studies. In this meta-analysis, traditional funnel plot, Begg’s funnel plot, Egger’s weighted regression (p = 0.13) as well as Begg’s rank correlation statistic (p = 0.676) revealed no evidence of publication bias. Conclusion: The present systematic review and meta-analysis found that maternal periconception folic acid supplementation was significantly associated with the risk of congenital heart defects. The risk of congenital heart defects was significantly reduced by 21% among those children of mothers who use periconceptional folic acid supplementations in high-income countries. We recommend that a large prospective study be conducted to investigate the association between maternal periconceptional folic acid supplementation and occurrence of congenital heart defect of various types, especially in the developing countries.
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Affiliation(s)
- Amsalu Taye Wondemagegn
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mekbeb Afework
- Department of Anatomy, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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24
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Asim A, Agarwal S, Dean DD. Maternal Risk Factors Triggering Congenital Heart Defects in Down Syndrome: A Case-Control Study. Pediatr Rep 2022; 14:99-105. [PMID: 35324818 PMCID: PMC8950734 DOI: 10.3390/pediatric14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/04/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Maternal MTHFR and MTRR polymorphisms as a risk of CHD in DS fetus were studied along with maternal folic acid supplementation, which could influence the folate metabolism along with other risk factors. MATERIAL AND METHODS A case-control study comprising of mothers of DS with and without CHD along with controls were recruited from a tertiary care center since 2018-2019. Genomic DNA was isolated followed by PCR-RFLP. RESULTS Mothers with age ≥35 years and having history of miscarriages have a higher risk of giving birth to DS with CHD (n = 35% and 42%, respectively). Mothers who carried the MTHFR 677CT/TT and MTRR 524CT/TT genotypes combination in the folic acid nonusers group during pregnancies had six-fold (OR = 6.909, p-value = 0.027; 95% CI-1.23 ± 38.51) and four-fold (OR = 4.75, p-value = 0.040; 95% CI-1.067 ± 21.44) increased odds of having a DS child with CHD, respectively, as compared to folic acid users. CONCLUSION Maternal age, folic acid supplementation, and previous history of miscarriages is involved in the etiology of CHD in DS fetus in Indian population. Maternal MTHFR and MTRR polymorphisms are also involved in the occurrence of CHD and DS in Indian population when controlling for periconceptional folic acid supplementation. LIMITATIONS Single-Centered Study.
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25
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Strzelecka I, Słodki M, Chrzanowski J, Rizzo G, Respondek-Liberska M. An investigation of the optimal inter-pregnancy interval following pregnancy with a fetus with congenital heart disease. Arch Med Sci 2022; 18:388-394. [PMID: 35316911 PMCID: PMC8924819 DOI: 10.5114/aoms.2019.86186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/20/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Congenital heart defects (CHD) are one of the most commonly diagnosed congenital malformations in fetuses and newborns. The aim of the study was to determine whether inter-pregnancy interval (IPI), maternal age or number of pregnancies had any influence on the recurrence of congenital heart disease in subsequent pregnancies. MATERIAL AND METHODS We found in our database 144 women with subsequent pregnancies after CHD in a previous pregnancy. Each woman was selected according to the eligibility and exclusion criteria. Medical history as well as obstetrics history were recorded. Comparisons of groups with and without a recurrence of CHD were performed. We calculated hazard ratios for recurrence of CHD. We also performed analysis of the impact of confounding variables: maternal age and parity. Missing data were excluded from the analysis. Smoking habits as well as socio-demographic characteristics were not evaluated in this study. RESULTS A higher risk of recurrence of CHD correlated with a shorter IPI, with a median of 11 months compared with 24 months for the group of healthy fetuses in subsequent pregnancy. The results were statistically significant. Parity was proven to be an important confounder of the study. Multivariable analysis including parity and maternal age did not affect the confidence intervals of hazard ratios for IPI. CONCLUSIONS The optimal IPI to reduce the risk of recurrence of CHD is 24 months. Shorter intervals are related to a higher risk of recurrence of CHD in the next pregnancy and are independent on the age of the woman and parity.
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Affiliation(s)
- Iwona Strzelecka
- Department of Diagnoses and Prevention of Fetal Malformations, Medical University of Lodz, Poland
| | - Maciej Słodki
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Jędrzej Chrzanowski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Giuseppe Rizzo
- Department of Maternal Fetal Medicine, Ospedale Cristo Re Roma Università di Roma Tor Vergata, Rome, Italy
| | - Maria Respondek-Liberska
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
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26
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Wang D, Jin L, Zhang J, Meng W, Ren A, Jin L. Maternal Periconceptional Folic Acid Supplementation and Risk for Fetal Congenital Heart Defects. J Pediatr 2022; 240:72-78. [PMID: 34508748 DOI: 10.1016/j.jpeds.2021.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine the effects of maternal periconceptional supplementation with folic acid or multiple micronutrients containing folic acid on the prevention of fetal congenital heart defects (CHDs). STUDY DESIGN Data were drawn from a Prenatal Health Care System and a Birth Defects Surveillance System in a district of Beijing, China. A total of 63 969 singleton births, live or stillborn, 308 CHDs among them, during 2013 to 2018 were included. Associations between different patterns of supplementation and risk for total CHDs or main types of CHDs were evaluated with risk ratios (RRs). RESULTS For folic acid or multiple micronutrients containing folic acid users compared with nonusers, the adjusted RRs (ARRs) for total CHDs, critical CHD, and ventricular septal defect (VSD) were 0.60 (95% CI, 0.44-0.83), 0.41 (95% CI, 0.26-0.67), and 0.47 (95% CI, 0.30-0.74), respectively. When we compared multiple micronutrients containing folic acid users with folic acid users, the ARRs were 0.84 (95% CI, 0.66-1.09), 0.64 (95% CI, 0.41-1.00), and 0.94 (95% CI, 0.63-1.41) for total CHDs, critical CHD, and VSD, respectively. We also found that, compared with supplementation initiated after conception, supplementation initiated before conception was associated with a lower risk for CHDs: the ARRs were 0.68 (95% CI, 0.48-0.95) for total CHDs and 0.26 (95% CI, 0.10-0.71) for critical CHD, but 1.08 (95% CI, 0.63-1.83) for VSD. CONCLUSIONS Maternal periconceptional supplementation with folic acid or multiple micronutrients containing folic acid seems to decrease the risk for CHDs, especially critical CHD, in offspring. Supplementation confers a greater protective effect when it is initiated before conception. We did not find any difference between folic acid and multiple micronutrients containing folic acid in terms of preventing CHDs.
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Affiliation(s)
- Di Wang
- Institute of Reproductive and Child Health, Peking University/National Health Commission Key Laboratory, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Hospital, Beijing, China.
| | - Jie Zhang
- Institute of Reproductive and Child Health, Peking University/National Health Commission Key Laboratory, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Tongzhou Maternal and Child Health Hospital, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Peking University/National Health Commission Key Laboratory, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, Peking University/National Health Commission Key Laboratory, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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27
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Zhong T, Song X, Liu Y, Sun M, Zhang S, Chen L, Diao J, Li J, Li Y, Shu J, Wei J, Zhu P, Wang T, Qin J. Association of methylenetetrahydrofolate reductase gene polymorphisms and maternal folic acid use with the risk of congenital heart disease. Front Pediatr 2022; 10:939119. [PMID: 36160803 PMCID: PMC9492935 DOI: 10.3389/fped.2022.939119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To systematically evaluate the association of MTHFR genetic polymorphisms, maternal folic acid intake, and the time when folic acid intake was started with the risk of congenital heart disease (CHD) and investigated the role of their interaction on infant CHD risk in Chinese populations. METHODS A case-control study involving 592 CHD cases, 617 health controls, and their mothers was performed. The exposures of interest were single nucleotide polymorphisms (SNPs) of the MTHFR gene, maternal folic acid use, and the time when folic acid use was started. We applied the logistic regression model to explore the strength of association. RESULTS Our findings showed that mothers lacking folic acid intake had a significantly higher risk of CHD in offspring (aOR = 2.00; 95%CI: 1.34-2.98). Mothers who started to use folic acid from the first trimester of the fetation (aOR = 1.65; 95% CI: 1.22-2.23) or from the second trimester of the fetation (aOR = 7.77; 95% CI: 2.52-23.96), compared with those starting to use folic acid from 3 months previous to the conception, were at a significantly higher risk of CHD in offspring. Genetic variants at rs2066470 (AA vs. GG: aOR = 5.09, 95%CI: 1.99-13.03), rs1801133 (AA vs. GG: aOR = 2.49, 95%CI: 1.58-3.93), and rs1801131 (TG vs. TT: aOR = 1.84, 95%CI: 1.36-2.50; GG vs. TT: aOR = 3.58, 95%CI: 1.68-7.63) were significantly associated with the risk of CHD based on the multivariate analysis. Additionally, statistically significant interactions between maternal folic acid intake and genetic variants of the MTHFR gene at rs1801133 and rs1801131 were observed. CONCLUSION An association of maternal folic acid intake and the time when intake was started with the risk of CHD in offspring was found. What's more, maternal folic acid fortification may help counteract partial of the risks of CHD in offspring attributable to MTHFR genetic mutations. REGISTRATION NUMBER http://www.chictr.org.cn/edit.aspx?pid=28300&htm=4, identifier: ChiCTR1800016635.
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Affiliation(s)
- Taowei Zhong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xinli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Letao Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jingyi Diao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jinqi Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yihuan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Shu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,National Health Council (NHC) Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,National Health Council (NHC) Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
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28
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Wilson R, O'Connor D. Maternal folic acid and multivitamin supplementation: International clinical evidence with considerations for the prevention of folate-sensitive birth defects. Prev Med Rep 2021; 24:101617. [PMID: 34976673 PMCID: PMC8684027 DOI: 10.1016/j.pmedr.2021.101617] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/17/2022] Open
Abstract
More evidence is available for maternal intake, absorption, distribution, tissue specific concentrations, and pregnancy outcomes with folic acid (fortification/supplementation) during preconception - first trimester. This Quality Improvement prevention review used expert guidelines/opinions, systematic reviews, randomized control trials/controlled clinical trials, and observational case control/case series studies, published in English, from 1990 to August 2021. Optimization for an oral maternal folic acid supplementation is difficult because it relies on folic acid dose, type of folate supplement, bio-availability of the folate from foods, timing of supplementation initiation, maternal metabolism/genetic factors, and many other factors. There is continued use of high dose pre-food fortification 'RCT evidenced-based' folic acid supplementation for NTD recurrence pregnancy prevention. Innovation requires preconception and pregnancy use of 'carbon one nutrient' supplements (folic acid, vitamin B12, B6, choline), using the appropriate evidence, need to be considered. The consideration and adoption of directed personalized approaches for maternal complex risk could use serum folate testing for supplementation dosing choice. Routine daily folic acid dosing for low-risk women should consider a multivitamin with 0.4 mg of folic acid starting 3 months prior to conception until completion of breastfeeding. Routine folic acid dosing or preconception measurement of maternal serum folate (after 4-6 weeks of folate supplementation) could be considered for maternal complex risk group with genetic/medical/surgical co-morbidities. These new approaches for folic acid oral supplementation are required to optimize benefit (decreasing folate sensitive congenital anomalies; childhood morbidity) and minimizing potential maternal and childhood risk.
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Affiliation(s)
- R.D. Wilson
- Cumming School of Medicine, Department of Obstetrics and Gynecology, University of Calgary, FMC NT 435, 1403 29 St NW, Calgary, Alberta, Canada
| | - D.L. O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Zhang J, Jin L, Wang D, Wang C, Tong M, Yu J, Meng W, Ren A, Jin L. Maternal periconceptional folic acid supplements use and fetus risk for limb defects. Paediatr Perinat Epidemiol 2021; 35:645-653. [PMID: 34060120 DOI: 10.1111/ppe.12775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/09/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Associations between the periconceptional folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) supplementation and risk for limb defects are inconsistent. OBJECTIVE To explore the association between periconceptional folic acid supplements use and risk for limb defects, including clubfoot, polydactyly, syndactyly, and limb deficiencies. METHODS Data were derived from a cohort based on a pregnancy registry in a district of Beijing, China, from 2013 to 2018. Information on maternal periconceptional FAO and MMFA supplementation was collected via face-to-face interviews at first trimester. Pregnancy outcomes including limb defects were ascertained in livebirths, stillbirths, and elective pregnancy terminations and were recorded into the system. Propensity score methods were used to adjust for potential confounders. RESULTS A total of 63 969 women with a singleton delivery were included. The overall prevalence of limb defects was 47.5 per 10 000 (n = 63 969) singleton deliveries. Decreased prevalence of limb defects was found among FAO/MMFA users compared with women who did not take supplements (nonusers) (46.1 vs. 61.9 per 10 000 births, adjusted risk ratio [RR] 0.80, 95% confidence interval [CI] 0.56, 1.12). Compared with nonusers (n = 6462, 10.2%), women who took either FAO (n = 26 567, 42.0%) or MMFA (n = 30 259, 47.8%) had a lower risk for total clubfoot (RR 0.40, 95% CI 0.20, 0.84), and for isolated clubfoot (RR 0.41, 95% CI 0.17, 0.97). For other limb defects except clubfoot, FAO supplementation did not appear to be associated with reduced risk, while MMFA supplementation group had 30%-50% reduced risks for other limb defects. A lower risk for limb defects or isolated limb defects was found with MMFA supplementation when FAO supplementation was used as a control. CONCLUSIONS Maternal periconceptional supplements with either FAO or MMFA had inverse association with clubfoot in offspring, and MMFA was associated with lower risk for isolated limb defects compared with FAO.
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Affiliation(s)
- Jie Zhang
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Hospital, Beijing, China
| | - Di Wang
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Cheng Wang
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Mingkun Tong
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jinhui Yu
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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González-Peña SM, Calvo-Anguiano G, Martínez-de-Villarreal LE, Ancer-Rodríguez PR, Lugo-Trampe JJ, Saldivar-Rodríguez D, Hernández-Almaguer MD, Calzada-Dávila M, Guerrero-Orjuela LS, Campos-Acevedo LD. Maternal Folic Acid Intake and Methylation Status of Genes Associated with Ventricular Septal Defects in Children: Case-Control Study. Nutrients 2021; 13:nu13062071. [PMID: 34204335 PMCID: PMC8234530 DOI: 10.3390/nu13062071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/28/2022] Open
Abstract
Background: DNA methylation is the best epigenetic mechanism for explaining the interactions between nutrients and genes involved in intrauterine growth and development programming. A possible contributor of methylation abnormalities to congenital heart disease is the folate methylation regulatory pathway; however, the mechanisms and methylation patterns of VSD-associated genes are not fully understood. Objective: To determine if maternal dietary intake of folic acid (FA) is related to the methylation status (MS) of VSD-associated genes (AXIN1, MTHFR, TBX1, and TBX20). Methods: Prospective case–control study; 48 mothers and their children were evaluated. The mothers’ dietary variables were collected through a food frequency questionnaire focusing on FA and the consumption of supplements with FA. The MS of promoters of genes was determined in the children. Results: The intake of FA supplements was significantly higher in the control mothers. In terms of maternal folic acid consumption, significant differences were found in the first trimester of pregnancy. Significant differences were observed in the MS of MTHFR and AXIN1 genes in VSD and control children. A correlation between maternal FA supplementation and MS of AXIN1 and TBX20 genes was found in control and VSD children, respectively. Conclusions: A lower MS of AXIN1 genes and a higher MS of TBX20 genes is associated with FA maternal supplementation.
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Affiliation(s)
- Sandra M. González-Peña
- Clinical Nutrition, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (S.M.G.-P.); (P.R.A.-R.)
- International Iberoamerican University of México, Campeche 24560, Mexico
| | - Geovana Calvo-Anguiano
- Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (G.C.-A.); (L.E.M.-d.-V.); (J.J.L.-T.); (M.D.H.-A.); (M.C.-D.)
| | - Laura E. Martínez-de-Villarreal
- Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (G.C.-A.); (L.E.M.-d.-V.); (J.J.L.-T.); (M.D.H.-A.); (M.C.-D.)
| | - Patricia R. Ancer-Rodríguez
- Clinical Nutrition, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (S.M.G.-P.); (P.R.A.-R.)
| | - José J. Lugo-Trampe
- Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (G.C.-A.); (L.E.M.-d.-V.); (J.J.L.-T.); (M.D.H.-A.); (M.C.-D.)
| | - Donato Saldivar-Rodríguez
- Gynecology and Obstetrics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico;
| | - María D. Hernández-Almaguer
- Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (G.C.-A.); (L.E.M.-d.-V.); (J.J.L.-T.); (M.D.H.-A.); (M.C.-D.)
- Medicine Faculty, Autonomous University of Baja California, Mexicali 21000, Mexico
| | - Melissa Calzada-Dávila
- Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (G.C.-A.); (L.E.M.-d.-V.); (J.J.L.-T.); (M.D.H.-A.); (M.C.-D.)
| | | | - Luis D. Campos-Acevedo
- Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey 64460, Mexico; (G.C.-A.); (L.E.M.-d.-V.); (J.J.L.-T.); (M.D.H.-A.); (M.C.-D.)
- Correspondence: ; Tel.: +52-01-81-8348-3704
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Friedman P, Yilmaz A, Ugur Z, Jafar F, Whitten A, Ustun I, Turkoglu O, Graham S, Bahado Singh R. Urine metabolomic biomarkers for prediction of isolated fetal congenital heart defect. J Matern Fetal Neonatal Med 2021; 35:6380-6387. [PMID: 33944672 DOI: 10.1080/14767058.2021.1914572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To identify maternal second and third trimester urine metabolomic biomarkers for the detection of fetal congenital heart defects (CHDs). STUDY DESIGN This was a prospective study. Metabolomic analysis of randomly collected maternal urine was performed, comparing pregnancies with isolated, non-syndromic CHDs versus unaffected controls. Mass spectrometry (liquid chromatography and direct injection and tandem mass spectrometry, LC-MS-MS) as well as nuclear magnetic resonance spectrometry, 1H NMR, were used to perform the analyses between 14 0/7 and 37 0/7 weeks gestation. A total of 36 CHD cases and 41 controls were compared. Predictive algorithms using urine markers alone or combined with, clinical and ultrasound (US) (four-chamber view) predictors were developed and compared. RESULTS A total of 222 metabolites were identified, of which 16 were overlapping between the two platforms. Twenty-three metabolite concentrations were found in significantly altered in CHD gestations on univariate analysis. The concentration of methionine was most significantly altered. A predictive algorithm combining metabolites (histamine, choline, glucose, formate, methionine, and carnitine) plus US four-chamber view achieved an AUC = 0.894; 95% CI, 0814-0.973 with a sensitivity of 83.8% and specificity of 87.8%. Enrichment pathway analysis identified several lipid related pathways that are dysregulated in CHD, including phospholipid biosynthesis, phosphatidylcholine biosynthesis, phosphatidylethanolamine biosynthesis, and fatty acid metabolism. This could be consistent with the increased risk of CHD in diabetic pregnancies. CONCLUSIONS We report a novel, noninvasive approach, based on the analysis of maternal urine for isolated CHD detection. Further, the dysregulation of lipid- and folate metabolism appears to support prior data on the mechanism of CHD.
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Affiliation(s)
- Perry Friedman
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Ali Yilmaz
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Zafer Ugur
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Faryal Jafar
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Amy Whitten
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Ilyas Ustun
- Center for Data Science,DePaul University School of Computing, Chicago, IL, USA
| | - Onur Turkoglu
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Stewart Graham
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
| | - Ray Bahado Singh
- Division of Maternal Fetal Medicine, William Beaumont Health, Royal Oak, MI, USA
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Yi K, Ma YH, Wang W, Zhang X, Gao J, He SE, Xu XM, Ji M, Guo WF, You T. The Roles of Reduced Folate Carrier-1 (RFC1) A80G (rs1051266) Polymorphism in Congenital Heart Disease: A Meta-Analysis. Med Sci Monit 2021; 27:e929911. [PMID: 33935279 PMCID: PMC8103792 DOI: 10.12659/msm.929911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background We performed the present study to better elucidate the correlation of reduced folate carrier-1 (RFC1) A80G (rs1051266) polymorphism with the risk of congenital heart disease (CHD). Material/Methods According to the designed search strategy, a systematic literature search was performed through the PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, VIP, and Wan Fang databases to collect published case-control studies on the correlation between RFC1 A80G polymorphism and CHD. All relevant studies up to October 1, 2019 were identified. The odds ratio (OR) and 95% confidence interval (CI) of the genotype distribution were used as the effect indicators. Results A total of 6 eligible studies was finally included in our meta-analysis, including 724 children with CHD, 760 healthy children, 258 mothers of the children with CHD, and 334 mothers of healthy control children. The meta-analysis revealed that for fetal analysis, only in the heterozygous model (GA vs GG, OR=1.36, 95% CI [1.06, 1.75], P=0.02) was RFC1 A80G polymorphism associated with risk of CHD. In maternal analysis, 3 genetic models of RFC1 A80G polymorphism increased the risk of CHD: the allelic model (A vs G, OR=1.36, 95% CI [1.07, 1.71], P=0.01), the homozygote model (AA vs GG, OR=2.99, 95%CI [1.06, 8.41], P=0.04), and the dominance model (GA+AA vs GG, OR=1.53, 95%CI [1.08, 2.16], P=0.02). Conclusions The maternal RFC1 A80G polymorphism has a strong correlation with CHD. Compared with the G allele, the A allele increases the risk of CHD by 0.36-fold.
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Affiliation(s)
- Kang Yi
- Department of Cardiovascular Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, China (mainland).,Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland)
| | - Yu-Hu Ma
- Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland).,The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Wei Wang
- Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland).,The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Xin Zhang
- Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland).,Gansu University of Chinese Medicine, Lanzhou, Gansu, China (mainland)
| | - Jie Gao
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China (mainland).,Gansu University of Chinese Medicine, Lanzhou, Gansu, China (mainland)
| | - Shao-E He
- Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland).,The Second Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Xiao-Min Xu
- Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland).,The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Meng Ji
- Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland).,The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Wen-Fen Guo
- Department of Cardiology, Baiyin Third People's Hospital, Baiyin, Gansu, China (mainland)
| | - Tao You
- Department of Cardiovascular Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, China (mainland).,Congenital Heart Disease Diagnosis and Treatment, Gansu Province International Science and Technology Cooperation Base, Lanzhou, Gansu, China (mainland)
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Ford SM, Pedersen CJ, Ford MR, Kim JW, Karunamuni GH, McPheeters MT, Jawaid S, Jenkins MW, Rollins AM, Watanabe M. Folic acid prevents functional and structural heart defects induced by prenatal ethanol exposure. Am J Physiol Heart Circ Physiol 2021. [DOI: 10.1152/ajpheart.00817.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
State-of-the-art biophotonic tools captured blood flow and endocardial cushion volumes in tiny beating quail embryo hearts, an accessible model for studying four-chambered heart development. Both hemodynamic flow and endocardial cushion volumes were altered with ethanol exposure but normalized when folic acid was introduced with ethanol. Folic acid supplementation preserved hemodynamic function that is intimately involved in sculpting the heart from the earliest stages of heart development.
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Affiliation(s)
- Stephanie M. Ford
- Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Division of Pediatric Cardiology, Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Cameron J. Pedersen
- Department of Biomedical Engineering, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Matthew R. Ford
- Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland Ohio
| | - Jun W. Kim
- Division of Pediatric Cardiology, Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ganga H. Karunamuni
- Division of Pediatric Cardiology, Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Matthew T. McPheeters
- Department of Biomedical Engineering, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Safdar Jawaid
- Division of Pediatric Cardiology, Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Michael W. Jenkins
- Division of Pediatric Cardiology, Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Department of Biomedical Engineering, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Andrew M. Rollins
- Department of Biomedical Engineering, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Michiko Watanabe
- Division of Pediatric Cardiology, Department of Pediatrics, The Congenital Heart Collaborative, Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Patel J, Bircan E, Tang X, Orloff M, Hobbs CA, Browne ML, Botto LD, Finnell RH, Jenkins MM, Olshan A, Romitti PA, Shaw GM, Werler MM, Li J, Nembhard WN. Paternal genetic variants and risk of obstructive heart defects: A parent-of-origin approach. PLoS Genet 2021; 17:e1009413. [PMID: 33684136 PMCID: PMC7971842 DOI: 10.1371/journal.pgen.1009413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/18/2021] [Accepted: 02/10/2021] [Indexed: 12/17/2022] Open
Abstract
Previous research on risk factors for obstructive heart defects (OHDs) focused on maternal and infant genetic variants, prenatal environmental exposures, and their potential interaction effects. Less is known about the role of paternal genetic variants or environmental exposures and risk of OHDs. We examined parent-of-origin effects in transmission of alleles in the folate, homocysteine, or transsulfuration pathway genes on OHD occurrence in offspring. We used data on 569 families of liveborn infants with OHDs born between October 1997 and August 2008 from the National Birth Defects Prevention Study to conduct a family-based case-only study. Maternal, paternal, and infant DNA were genotyped using an Illumina Golden Gate custom single nucleotide polymorphism (SNP) panel. Relative risks (RR), 95% confidence interval (CI), and likelihood ratio tests from log-linear models were used to estimate the parent-of-origin effect of 877 SNPs in 60 candidate genes in the folate, homocysteine, and transsulfuration pathways on the risk of OHDs. Bonferroni correction was applied for multiple testing. We identified 3 SNPs in the transsulfuration pathway and 1 SNP in the folate pathway that were statistically significant after Bonferroni correction. Among infants who inherited paternally-derived copies of the G allele for rs6812588 in the RFC1 gene, the G allele for rs1762430 in the MGMT gene, and the A allele for rs9296695 and rs4712023 in the GSTA3 gene, RRs for OHD were 0.11 (95% CI: 0.04, 0.29, P = 9.16x10-7), 0.30 (95% CI: 0.17, 0.53, P = 9.80x10-6), 0.34 (95% CI: 0.20, 0.57, P = 2.28x10-5), and 0.34 (95% CI: 0.20, 0.58, P = 3.77x10-5), respectively, compared to infants who inherited maternally-derived copies of the same alleles. We observed statistically significant decreased risk of OHDs among infants who inherited paternal gene variants involved in folate and transsulfuration pathways. Obstructive heart defects are birth defects that cause obstruction to the blood flow of the developing heart. Common OHDs include coarctation of the aorta, aortic stenosis and pulmonary stenosis. While there is a fair amount of literature indicating an association between maternal genetic variants and OHDs, less is known about the role of paternal genetic variants in the etiology of OHDs. We used a genotype clustering algorithm, SNPMClust, that was developed in-house at the Arkansas Center for Birth Defects Research and Prevention to study the role of paternal genetic variants in the folate, homocysteine and transsulfuration pathways. Maternal, paternal, and infant DNA specimens were collected from participants of the National Birth Defects Prevention Study, a large population-based case-control study in the United States, and were genotyped using an Illumina Golden Gate custom single nucleotide polymorphism (SNP) panel. We identified 4 SNPs in the folate and transsulfuration pathways, rs6812588, rs1762430, rs9296695, and rs4712023, that were associated with a statistically significant decreased risk of OHDs for infants who inherited a paternally-derived copy of the variant allele compared to infants who inherited a maternal copy of the variant allele. In conclusion, we observed a significantly decreased risk and less epigenetic influence of paternal genetic variants on OHDs compared to maternally-derived variants.
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Affiliation(s)
- Jenil Patel
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, United States of America
| | - Emine Bircan
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Xinyu Tang
- Biostatistics Program, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children’s Research Institute, Little Rock, AR, United States of America
| | - Mohammed Orloff
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Charlotte A. Hobbs
- Rady Children’s Institute for Genomic Medicine, San Diego, CA, United States of America
| | - Marilyn L. Browne
- Birth Defects Research Section, New York State Department of Health, Albany, NY, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, United States of America
| | - Lorenzo D. Botto
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UT, United States of America
| | - Richard H. Finnell
- Department of Molecular and Cellular Biology, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, United States of America
| | - Mary M. Jenkins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Andrew Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Paul A. Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, United States of America
| | - Gary M. Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Martha M. Werler
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, United States of America
| | - Jingyun Li
- Biostatistics Program, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children’s Research Institute, Little Rock, AR, United States of America
| | - Wendy N. Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
- * E-mail:
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Fazekas-Pongor V, Csáky-Szunyogh M, Fekete M, Mészáros Á, Cseh K, Pénzes M. Congenital heart diseases and parental occupational exposure in a Hungarian case-control study in 1997 to 2002. Congenit Anom (Kyoto) 2021; 61:55-62. [PMID: 33140474 DOI: 10.1111/cga.12401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 12/01/2022]
Abstract
The etiology of congenital heart diseases is not fully understood yet, however, endocrine disrupting chemicals may have a causative role in their development. The purpose of our study was to examine the association between congenital heart diseases and periconceptional parental occupational exposure to endocrine disrupting chemicals. In our Hungarian population-based case-control study, we examined 2263 live born cases with any congenital heart disease and 6789 matched controls selected between years 1997 to 2002. Occupational exposure was assessed with a job-exposure matrix developed for endocrine disrupting chemicals. Conditional multiple logistic regression analyses were performed to test associations between parental occupational exposure to endocrine disrupting chemicals and congenital heart diseases of the offspring as a whole and by congenital heart disease subtypes. The prevalence of exposure to endocrine disrupting chemicals was 4.5% for both case and control mothers and 19.1% and 19.4% for case and control fathers, respectively. We found a positive association between paternal pesticide (adjusted odds ratio = 1.66, 95% confidence interval: 1.03-2.69) and alkylphenolic compound exposure (adjusted odds ratio = 1.95, 95% confidence interval: 1.30-2.93) and the development of patent ductus arteriosus in the offspring. Alkylphenolic compound exposure occurred among painters, famers, and those working in the food service industry, while pesticide exposure occurred predominantly among farm workers. We identified that certain occupations may increase the occurrence of certain congenital heart disease phenotypes in the offspring. By paying closer attention to those working in these areas, antenatal detection rates of congenital heart diseases may be improved.
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Affiliation(s)
- Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Melinda Csáky-Szunyogh
- Hungarian Congenital Abnormalities Registry, National Public Health Center, Budapest, Hungary
| | - Mónika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ágota Mészáros
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Károly Cseh
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Melinda Pénzes
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Zhang Y, Qiu J, Zhou M, He X, Cui H, Xu X, Lv L, Lin X, Zhang C, Zhang H, Xu R, Yi B, Mao B, Huang H, Jin L, Zhuo H, Sun P, Liu Q, Zhang Y. Cooking stoves and risk of birth defects in urban China. ENVIRONMENTAL RESEARCH 2021; 194:110731. [PMID: 33453184 DOI: 10.1016/j.envres.2021.110731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/20/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Birth defects are a leading cause of infant death. Pregnant women spend a large amount of time indoors, and little research from population-based studies has investigated the association between indoor air pollution and birth defects. We aimed to examine whether using coal, biomass, or electromagnetic stoves for cooking is associated with risk of birth defects compared to using gas stoves. METHODS A birth cohort study was conducted from 2010 to 2012 in Lanzhou, China. Cases (n = 264) were singleton births with birth defects, which were defined as abnormalities of structure or function, including metabolism, presented at birth based on the International Classification of Diseases (ICD)-10 codes. Controls (n = 9926) were defined as singleton live births without birth defects. Unconditional logistic regression models were employed to estimate the association adjusting for confounding variables. RESULTS Compared to gas stoves for cooking, biomass (OR = 2.66, 95%CI: 1.38-5.13), and electromagnetic stove (OR = 1.90, 95%CI: 1.26-2.88) for cooking were associated with an increased risk of birth defects. The significant associations remained among non-congenital heart disease (CHD) defects but not CHDs. CONCLUSIONS Using biomass or electromagnetic stoves for cooking during pregnancy was associated with an increased risk of birth defects. Additional studies are warranted to confirm these novel findings. Studies with larger sample size or greater statistical power are also warranted to better estimate the associations for individual birth defects.
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Affiliation(s)
- Yaqun Zhang
- Department of Ecology and Environment of Gansu Province, Lanzhou, Gansu, China.
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Min Zhou
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaochun He
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Hongmei Cui
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Ling Lv
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaojuan Lin
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Chong Zhang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Honghong Zhang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Ruifeng Xu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Bin Yi
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Huang Huang
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Lan Jin
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Haoran Zhuo
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Peiyuan Sun
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China.
| | - Yawei Zhang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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ŞİMŞEK H, KARAAĞAÇ Y, TUNÇER E, YARDIMCI H. Gebelikte Folik Asit, B12 Vitamini, D Vitamini ve İyot Destekleri Kullanmak Gerekli Midir?: Olası Riskler. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.832401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Zhang R, Guo L, Zhao D, Qu P, Dang S, Yan H. Maternal B-vitamin intake and B-vitamin supplementation during pregnancy in relation to neonatal congenital heart defects: a case-control study with propensity score matching. Eur J Clin Nutr 2020; 75:782-791. [PMID: 33199851 DOI: 10.1038/s41430-020-00804-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 10/09/2020] [Accepted: 10/31/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVES The effect of dietary folate intake or folic acid (FA) supplementation during pregnancy on neonatal congenital heart defects (CHDs) remains inconclusive. There are limited data about non-folate-B-vitamin intake and the risk of CHDs. Furthermore, few studies have investigated dietary B-vitamin intake and B-vitamin supplement use simultaneously in relation to the risk of CHDs. This study aimed to explore the associations between maternal folate, vitamin B6, and vitamin B12 intake (dietary intake, total intake from diet and supplements); B-vitamin supplement use during pregnancy; and the risk of CHDs using the propensity score matching (PSM) method. METHODS We conducted a case-control study and included 760 cases and 1600 controls in Shaanxi Province, China. Diet, supplement use and other information were collected through a questionnaire interview. By using the 1:2 ratio PSM method, 396 cases were matched with 792 controls. Conditional logistic regression was used to investigate the associations between maternal B-vitamin intake and supplement use during pregnancy and CHDs. RESULTS Higher maternal dietary and total intake of folate and vitamin B12 were associated with reduced risk of CHDs, and the tests for linear trend were significant. Compared with non-users, maternal FA + VB6 + VB12 containing supplement use during pregnancy (OR 0.61, 95%CI 0.40-0.94), FA supplement use during pregnancy (OR 0.70, 95%CI 0.50-0.98) and in the first trimester (OR 0.62, 95%CI 0.46-0.85) were associated with a lower risk of CHDs. CONCLUSIONS The findings of this study suggest that a higher intake of folate and vitamin B12 during pregnancy reduces the risk of CHDs.
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Affiliation(s)
- Ruo Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi Province, China
| | - Leqian Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Doudou Zhao
- Translational Medicine Center, Northwest Women's and Children's Hospital of Xi'an Jiaotong University Health Science Center, 1616 Yanxiang Road, Xi'an, 710061, Shaanxi Province, China
| | - Pengfei Qu
- Translational Medicine Center, Northwest Women's and Children's Hospital of Xi'an Jiaotong University Health Science Center, 1616 Yanxiang Road, Xi'an, 710061, Shaanxi Province, China
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, 710061, Shaanxi Province, China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, 710061, Shaanxi Province, China.
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, 710061, Shaanxi Province, China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, 710061, Shaanxi Province, China. .,Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, 710061, Shaanxi Province, China.
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Fazekas-Pongor V, Fekete M, Csáky-Szunyogh M, Cseh K, Pénzes M. Parental occupational exposure and congenital heart diseases in a Hungarian case-control study. Int Arch Occup Environ Health 2020; 94:515-527. [PMID: 33170344 PMCID: PMC8032570 DOI: 10.1007/s00420-020-01589-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 10/06/2020] [Indexed: 11/10/2022]
Abstract
Purpose Our study aimed to explore the effect of parental occupational exposure to endocrine disrupting chemicals (EDCs) on the development of congenital heart diseases (CHDs) in the offspring, and to compare job-exposure matrix (JEM)-assessed and self-reported occupational exposures with each other. Methods Live-born infants born in 2007–2008 were selected from the population-based Hungarian Case–Control Surveillance of Congenital Abnormalities Study. 577 cases with any CHDs were compared to 1731 matched controls. Parental periconceptional occupational exposure to EDCs was assessed by a JEM and by questionnaire-based self-reporting of parents. Multivariate conditional logistic regression analyses were conducted to explore associations between parental occupational exposure to EDCs and the entire spectrum of CHDs and by CHD subtypes in the offspring. Kappa statistics were also performed to determine the consistency among JEM-assessed and self-reported occupational exposure of parents. Results JEM-assessed paternal exposure to polychlorinated organic substances, phthalates, biphenolic compounds, and solvents were significantly associated with the entire spectrum of CHDs. Ventricular septal defects were significantly associated with paternal self-reported exposure to pesticides, while atrial septal defects were significantly associated to paternal JEM-assessed phthalate exposure. Paternal solvent exposure was significantly associated with atrial septal defects and right ventricle outflow tract obstructions. JEM-assessed and self-reported exposures to pesticides, heavy metals, and solvents exhibited poor agreement for mothers and slight agreement for fathers. Conclusion Even though parental occupational exposure to EDCs seems to have a minor impact on the occurrence of CHDs, the results of biological and environmental monitoring should be taken into consideration as well.
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Affiliation(s)
- Vince Fazekas-Pongor
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Üllői út 26, Budapest, 1085, Hungary.
| | - Mónika Fekete
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Üllői út 26, Budapest, 1085, Hungary
| | - Melinda Csáky-Szunyogh
- Hungarian Congenital Abnormalities Registry, National Public Health Center, Albert Flórián út 2-6, Budapest, 1097, Hungary
| | - Károly Cseh
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Üllői út 26, Budapest, 1085, Hungary
| | - Melinda Pénzes
- Department of Public Health, Faculty of Medicine, Semmelweis University Budapest, Üllői út 26, Budapest, 1085, Hungary
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Periconceptional use of cod liver oil, a vitamin D source, could decrease the risk of CHD in offspring. Cardiol Young 2020; 30:1445-1451. [PMID: 32856579 DOI: 10.1017/s1047951120002280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore if there is association between vitamin D supplementation through cod liver oil ingestion around the periconceptional period and the risk of developing severe CHD in offspring. Furthermore, we would examine the interaction between vitamin D and folic acid supplementation in the association. METHODS A case-control study was conducted in Shanghai Children's Medical Center, in which, a total of 262 severe CHD cases versus 262 controls were recruited through June 2016 to December 2017. All children were younger than 2 years. To reduce potential selection bias and to minimise confounding effects, propensity score matching was applied. RESULTS After propensity score matching, vitamin D supplementation seemed to be associated with decreased odds ratio of severe CHD (odds ratio = 0.666; 95% confidence intervals: 0.449-0.990) in the multivariable conditional logistic analysis. Furthermore, we found an additive interaction between vitamin D and folic acid supplementation (relative excess risk due to interaction = 0.810, 95% confidence intervals: 0.386-1.235) in the association. CONCLUSION The results suggested that maternal vitamin D supplementation could decrease the risk of offspring severe CHD; moreover, it could strengthen the protective effect of folic acid. The significance of this study lies in providing epidemiological evidence that vitamin D supplementation around the periconceptional period could be a potential nutritional intervention strategy to meet the challenge of increasing CHD.
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Yuan X, Liu Z, Zhu J, Yu P, Deng Y, Chen X, Li N, Li S, Yang S, Li J, Liu H, Li X. Association between prepregnancy body mass index and risk of congenital heart defects in offspring: an ambispective observational study in China. BMC Pregnancy Childbirth 2020; 20:444. [PMID: 32753039 PMCID: PMC7405421 DOI: 10.1186/s12884-020-03100-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/08/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Congenital heart defects (CHDs) are the most common birth defect around the world. Maternal prepregnancy obesity has been proposed as a risk factor of CHDs, but the relationship of CHD risk with over- and underweight is controversial, especially because body mass index (BMI) distribution differs between Asia and the West. The study aimed to examine the potential associations of maternal over- and underweight on risk of offspring CHDs. METHODS An ambispective observational study involving 1206 fetuses with CHDs and 1112 fetuses without defects at seven hospitals in China was conducted. Standardized questionnaires were used to collect information on maternal prepregnancy weight and height, social demographic characteristics, living and occupational environments, and lifestyle behaviors. Univariate, multivariate and multilevel logistic regression as well as unrestricted cubic spline analysis were used to examine potential associations of prepregnancy BMI and offspring CHDs. RESULTS Prepregnancy maternal underweight (BMI<18.5) or low average BMI (18.5 ≤ BMI<21.25) was associated with significantly higher risk of CHD in offspring than high average BMI (21.25 ≤ BMI<24.0): multilevel logistic regression indicated adjusted odds ratios of 1.53 (95%CI 1.13, 2.08) for underweight, 1.44 (95%CI 1.10, 1.89) for low average BMI and 1.29 (95%CI 0.84, 1.97) for overweight or obesity (BMI ≥ 24.0). Mothers with prepregnancy BMI < 21.25 were at greater risk of offspring with septal defects, while mothers with low average BMI were at greater risk of offspring with conotruncal defects and septal defects. CONCLUSIONS Our findings suggest that underweight or low average BMI may be associated with higher risk of CHDs in offspring. Health professionals may wish to advise women planning to be pregnant to maintain or even gain weight to ensure adequate, balanced nutrition and thereby reduce the risk of CHDs in their offspring.
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Affiliation(s)
- Xuelian Yuan
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhen Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ping Yu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Ying Deng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xinlin Chen
- Department of Ultrasound, Hubei Maternal and Child Healthcare Hospital, Wuhan, Hubei, China
| | - Nana Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Shengli Li
- Department of Ultrasound, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Shuihua Yang
- Department of Ultrasound, Guangxi Maternal and Child Healthcare Hospital, Nanning, Guangxi, China
| | - Jun Li
- Department of Ultrasonic Diagnosis, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hanmin Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20 Ren Min Nan Lu, Chengdu City, Sichuan Province, 610041, People's Republic of China.
| | - Xiaohong Li
- National Center for Birth Defect Monitoring of China, West China Second University Hospital, Sichuan University, No. 17 Ren Min Nan Lu, Chengdu City, Sichuan Province, 610041, People's Republic of China.
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Qu Y, Lin S, Zhuang J, Bloom MS, Smith M, Nie Z, Mai J, Ou Y, Wu Y, Gao X, Tan H, Liu X. First-Trimester Maternal Folic Acid Supplementation Reduced Risks of Severe and Most Congenital Heart Diseases in Offspring: A Large Case-Control Study. J Am Heart Assoc 2020; 9:e015652. [PMID: 32613868 PMCID: PMC7670504 DOI: 10.1161/jaha.119.015652] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Maternal folic acid supplementation (FAS) reduces the risk of neural tube defects in offspring. However, its effect on congenital heart disease (CHDs), especially on the severe ones remains uncertain. This study aimed to assess the individual and joint effect of first-trimester maternal FAS and multivitamin use on CHDs in offspring. Methods and Results This is a case-control study including 8379 confirmed CHD cases and 6918 controls from 40 healthcare centers of 21 cities in Guangdong Province, China. Adjusted odds ratios (aORs) of FAS and multivitamin use between CHD cases (overall and specific CHD phenotypes) and controls were calculated by controlling for parental confounders. The multiplicative interaction effect of FAS and multivitamin use on CHDs was estimated. A significantly protective association was detected between first-trimester maternal FAS and CHDs among offspring (aOR, 0.69; 95% CI, 0.62-0.76), but not for multivitamin use alone (aOR, 1.42; 95% CI, 0.73-2.78). There was no interaction between FAS and multivitamin use on CHDs (P=0.292). Most CHD phenotypes benefited from FAS (aORs ranged from 0.03-0.85), especially the most severe categories (ie, multiple critical CHDs [aOR, 0.16; 95% CI, 0.12-0.22]) and phenotypes (ie, single ventricle [aOR, 0.03; 95% CI, 0.004-0.21]). Conclusions First-trimester maternal FAS, but not multivitamin use, was substantially associated with lower risk of CHDs, and the association was strongest for the most severe CHD phenotypes. We recommend that women of childbearing age should supplement with folic acid as early as possible, ensuring coverage of the critical window for fetal heart development to prevent CHDs.
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Affiliation(s)
- Yanji Qu
- Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha Hunan China.,Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Shao Lin
- Department of Environmental Health SciencesUniversity at AlbanyState University of New York Rensselaer NY.,Department of Epidemiology and Biostatistics University at Albany State University of New York Rensselaer NY
| | - Jian Zhuang
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Michael S Bloom
- Department of Environmental Health SciencesUniversity at AlbanyState University of New York Rensselaer NY.,Department of Epidemiology and Biostatistics University at Albany State University of New York Rensselaer NY
| | - Maggie Smith
- Department of Environmental Health SciencesUniversity at AlbanyState University of New York Rensselaer NY
| | - Zhiqiang Nie
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Jinzhuang Mai
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Yanqiu Ou
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Yong Wu
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Xiangmin Gao
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha Hunan China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute WHO Collaborating Center for Research and Training in Cardiovascular Diseases Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou Guangdong China
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Yang J, Cheng Y, Zeng L, Dang S, Yan H. Maternal dietary diversity during pregnancy and congenital heart defects: a case-control study. Eur J Clin Nutr 2020; 75:355-363. [PMID: 32235888 DOI: 10.1038/s41430-020-0617-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES Maternal diet is critical to fetal development. This study aimed to explore the association between maternal dietary diversity during pregnancy and congenital heart defects (CHD) in Chinese population. METHODS A hospital-based case-control study was conducted including 474 cases and 948 controls in Northwest China. We recruited eligible women waiting for delivery in the hospital and gathered their diets during the whole pregnancy by a validated food frequency questionnaire. According to the FAO Minimum Dietary Diversity for Women (MDD-W) guideline, the participants were categorized into "inadequate dietary diversity score (DDS)" (DDS < 5) and "adequate DDS" (DDS ≥ 5) groups. The association between dietary diversity and CHD was estimated using the mixed logistic regression models. RESULTS Case mothers had a lower DDS during pregnancy than the controls (P < 0.001). The proportions of women consuming all the ten defined food groups were lower in the inadequate DDS group than in the adequate DDS group among both cases and controls (all P < 0.001). The prevalence of inadequate micronutrient intake was higher in the inadequate DDS group than in the adequate DDS group among both cases and controls (all P < 0.05). Women in the adequate DDS group had reduced risks of having fetuses with total CHD (OR = 0.62, 95% CI = 0.45-0.84) and ventricular septal defects (OR = 0.58, 95% CI = 0.38-0.88). CONCLUSIONS Adequate DDS during pregnancy might be associated with a lower risk of CHD in offspring. Efforts to promote dietary diversity during pregnancy need to be strengthened to reduce the prevalence of CHD in Chinese population.
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Affiliation(s)
- Jiaomei Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yue Cheng
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Lingxia Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Shaonong Dang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, China.
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. .,Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, Xi'an, Shaanxi, China. .,Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi, China.
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Kalisch-Smith JI, Ved N, Sparrow DB. Environmental Risk Factors for Congenital Heart Disease. Cold Spring Harb Perspect Biol 2020; 12:a037234. [PMID: 31548181 PMCID: PMC7050589 DOI: 10.1101/cshperspect.a037234] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Congenital heart disease (CHD) has many forms and a wide range of causes. Clinically, it is important to understand the causes. This allows estimation of recurrence rate, guides treatment options, and may also be used to formulate public health advice to reduce the population prevalence of CHD. The recent advent of sophisticated genetic and genomic methods has led to the identification of more than 100 genes associated with CHD. However, despite these great strides, to date only one-third of CHD cases have been shown to have a simple genetic cause. This is because CHD can also be caused by oligogenic factors, environmental factors, and/or gene-environment interaction. Although solid evidence for environmental causes of CHD have been available for almost 80 years, it is only very recently that the molecular mechanisms for these risk factors have begun to be investigated. In this review, we describe the most important environmental CHD risk factors, and what is known about how they cause CHD.
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Affiliation(s)
| | - Nikita Ved
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, Oxfordshire OX1 3PT, United Kingdom
| | - Duncan Burnaby Sparrow
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, Oxfordshire OX1 3PT, United Kingdom
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Genetics of Congenital Heart Disease. Biomolecules 2019; 9:biom9120879. [PMID: 31888141 PMCID: PMC6995556 DOI: 10.3390/biom9120879] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Congenital heart disease (CHD) is one of the most common birth defects. Studies in animal models and humans have indicated a genetic etiology for CHD. About 400 genes have been implicated in CHD, encompassing transcription factors, cell signaling molecules, and structural proteins that are important for heart development. Recent studies have shown genes encoding chromatin modifiers, cilia related proteins, and cilia-transduced cell signaling pathways play important roles in CHD pathogenesis. Elucidating the genetic etiology of CHD will help improve diagnosis and the development of new therapies to improve patient outcomes.
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Ha AVV, Zhao Y, Binns CW, Pham NM, Nguyen CL, Nguyen PTH, Chu TK, Lee AH. Low Prevalence of Folic Acid Supplementation during Pregnancy: A Multicenter Study in Vietnam. Nutrients 2019; 11:nu11102347. [PMID: 31581726 PMCID: PMC6835766 DOI: 10.3390/nu11102347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 01/05/2023] Open
Abstract
Periconceptional folic acid (FA) supplementation is recommended to prevent neural tube defects (NTDs), but little information is known about its use in Vietnam. It is important that FA supplements start to be taken when planning a pregnancy and continued through the first trimester to prevent NTDs, as the neural tube closes in the first month of pregnancy. However, FA supplementation in Vietnam is usually recommended to commence from the first antenatal visit, which is usually at 16 weeks, and very few women take FA before their first visit. This multicenter study aimed to determine the prevalence of FA supplement use and associated maternal characteristics in Vietnam. FA supplementation was assessed in 2030 singleton pregnant women between 2015 and 2016. In total, 654 (32.2%) women reported taking either supplements containing FA alone or multivitamins containing FA, and 505 (24.9%) reported correctly taking supplements containing FA alone. Women who were aged 30 years or over, had low education levels, had formal employment, and whose current pregnancy was first or unplanned were less likely to supplement with FA. Education programs are needed to encourage FA supplementation when contemplating pregnancy.
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Affiliation(s)
- Anh Vo Van Ha
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, 700000, Vietnam.
| | - Yun Zhao
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Ngoc Minh Pham
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam.
| | - Cong Luat Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
| | - Phung Thi Hoang Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
| | - Tan Khac Chu
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam.
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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Guo Y, Yu P, Zhu J, Yang S, Yu J, Deng Y, Li N, Liu Z. High maternal selenium levels are associated with increased risk of congenital heart defects in the offspring. Prenat Diagn 2019; 39:1107-1114. [PMID: 31461777 DOI: 10.1002/pd.5551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/15/2019] [Accepted: 08/18/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine whether maternal hair or cord blood selenium levels are associated with infant congenital heart defects (CHDs). METHOD A hospital-based case-control study was performed with samples collected from 2010 to 2014. Selenium levels in maternal hair and fetal cord serum were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Data from medical records of infants with CHDs were collected. Logistic regression analysis was employed to examine the independent association between maternal selenium exposure and fetal CHD. RESULTS In total, 888 pregnant women were included in this study. Median (interquartile range) selenium levels in of maternal hair was similar in the control and CHD group. A significant association was detected between increased maternal hair selenium concentration and CHDs in offspring (adjusted odds ratio [aOR] 3.57, 95 %CI, 1.90-6.70). The association was present in all CHD groups, including septal defects, conotruncal defects, left ventricular outflow tract obstruction, right ventricular outflow tract obstruction, and anomalous pulmonary venous return. CONCLUSION High maternal selenium level is significantly associated with the occurrence of fetal CHD.
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Affiliation(s)
- Yixiong Guo
- Department of birth defect molecular epidemiology laboratory, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.,Department of Biobank, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ping Yu
- Department of birth defect molecular epidemiology laboratory, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jun Zhu
- Department of birth defect molecular epidemiology laboratory, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.,National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Shuihua Yang
- Department of Ultrasound, Maternal and Child Healthcare Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jing Yu
- Department of Pediatric, Mianyang Central Hospital, Mianyang, China
| | - Ying Deng
- Department of birth defect molecular epidemiology laboratory, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.,National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Nana Li
- Department of birth defect molecular epidemiology laboratory, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Zhen Liu
- Department of birth defect molecular epidemiology laboratory, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.,National Center for Birth Defect Monitoring, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
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48
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Ki S, Kwon SH, Eum J, Raslan AA, Kim KN, Hwang BJ, Kee Y. 3D light-sheet assay assessing novel valproate-associated cardiotoxicity and folic acid relief in zebrafish embryogenesis. CHEMOSPHERE 2019; 227:551-560. [PMID: 31004822 DOI: 10.1016/j.chemosphere.2019.04.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
Precise in vivo toxicological assays to determine the cardiotoxicity of pharmaceuticals and their waste products are essential in order to evaluate their risks to humans and the environment following industrial release. In the present study, we aimed to develop the sensitive imaging-based cardiotoxicity assay and combined 3D light-sheet microscopy with a zebrafish model to identify hidden cardiovascular anomalies induced by valproic acid (VPA) exposure. The zebrafish model is advantageous for this assessment because its embryos remain transparent. The 3D spatial localization of fluorescence-labeled cardiac cells in and around the heart using light-sheet technology revealed dislocalization of the heart from the outflow tract in two-day-old zebrafish embryos treated with 50 μM and 100 μM VPA (P < 0.01) and those embryos exposed to 20 μM VPA presented hypoplastic distal ventricles (P < 0.01). These two observed phenotypes are second heart field-derived cardiac defects. Quantitative analysis of the light-sheet imaging demonstrated that folic acid (FA) supplementation significantly increased the numbers of endocardial and myocardial cells (P < 0.05) and the accretion of second heart field-derived cardiomyocytes to the arterial pole of the outflow tract. The heart rate increased in response to the cellular changes occurring in embryonic heart development (P < 0.05). The present study disclosed the cellular mechanism underlying the role of FA in spontaneous cellular changes in cardiogenesis and in VPA-associated cardiotoxicity. The 3D light-sheet assay may be the next-generation test to evaluate the risks of previously undetected pharmaceutical and environmental cardiotoxicities in both humans and animals.
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Affiliation(s)
- Seoyoung Ki
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea
| | - Seung-Hae Kwon
- Korea Basic Science Institute Chuncheon Center, Chuncheon, South Korea
| | - Juneyong Eum
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea
| | - Ahmed A Raslan
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea
| | - Kil-Nam Kim
- Korea Basic Science Institute Chuncheon Center, Chuncheon, South Korea
| | - Byung Joon Hwang
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea.
| | - Yun Kee
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea.
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Kocylowski R, Grzesiak M, Gaj Z, Lorenc W, Bakinowska E, Barałkiewicz D, von Kaisenberg CS, Lamers Y, Suliburska J. Associations between the Level of Trace Elements and Minerals and Folate in Maternal Serum and Amniotic Fluid and Congenital Abnormalities. Nutrients 2019; 11:E328. [PMID: 30717440 PMCID: PMC6413094 DOI: 10.3390/nu11020328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 12/27/2022] Open
Abstract
Congenital birth defects may result in a critical condition affecting the baby, including severe fetal/neonatal handicap and mortality. Several studies have shown that genetic, nutritional, and environmental factors may have an impact on fetal development and neonatal health. The relevance of essential and toxic elements on fetal development has not yet been fully investigated, and the results of recent research indicate that these elements may be crucial in the assessment of the risk of malformations in neonates. We determined the association between essential and toxic elements and the level of folate in maternal serum (MS) and amniotic fluid (AF), along with neonatal abnormalities. A total of 258 pregnant Polish women in the age group of 17⁻42 years participated in this study. AF and MS were collected during vaginal delivery or during cesarean section. An inductively coupled plasma mass spectrometry technique was used to determine the levels of various elements in AF and MS. The results of this exploratory study indicate that the levels of essential and toxic elements are associated with fetal and newborn anatomical abnormalities and growth disorders.
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Affiliation(s)
- Rafal Kocylowski
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
- PreMediCare New Med Medical Center, ul. Drużbickiego 13, 61-693 Poznan, Poland.
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
| | - Zuzanna Gaj
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
- Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
| | - Wiktor Lorenc
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznan, ul. Umultowska 89b, 61-614 Poznan, Poland.
| | - Ewa Bakinowska
- Institute of Mathematics, Poznan University of Technology, ul. Piotrowo 3A, 60-965 Poznan, Poland.
| | - Danuta Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznan, ul. Umultowska 89b, 61-614 Poznan, Poland.
| | - Constantin S von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
| | - Yvonne Lamers
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- British Columbia Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada.
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland, ul. Wojska Polskiego 31, 60-624 Poznan, Poland.
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50
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Chen Q, Feng Y, Yang H, Wu W, Zhang P, Wang K, Wang Y, Ko J, Shen J, Guo L, Zhao F, Du W, Ru S, Wang S, Zhang Y. A Vitamin Pattern Diet Is Associated with Decreased Risk of Gestational Diabetes Mellitus in Chinese Women: Results from a Case Control Study in Taiyuan, China. J Diabetes Res 2019; 2019:5232308. [PMID: 31089473 PMCID: PMC6476050 DOI: 10.1155/2019/5232308] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/28/2018] [Accepted: 01/17/2019] [Indexed: 01/01/2023] Open
Abstract
Identification of modifiable dietary factors, which are involved in the development of gestational diabetes mellitus (GDM), could inform strategies to prevent GDM. Therefore, we examined the dietary nutrient patterns and evaluated their relationship with GDM risk in a Chinese population using a case control study design. A total of 1,464 GDM cases and 8,092 non-GDM controls were included in the final analysis. Dietary intake was assessed using a 33-item food frequency questionnaire, and nutrients were estimated using the Chinese Standard Tables of Food Consumption. Dietary nutrient patterns were identified using factor analysis, and their associations with GDM risk were evaluated using unconditional logistic regression models adjusting for total energy intake, maternal age, high blood pressure, education, maternal body mass index (BMI), parity, and family history of diabetes. A "vitamin" nutrient pattern was characterized as the consumption of diet rich in vitamin A, carotene, vitamin B2, vitamin B6, vitamin C, dietary fiber, folate, calcium, and potassium. For every quartile increase in the vitamin factor score during one year prior to conception, the first trimester, and the second trimester of pregnancy, the GDM risk decreased by 9% (OR: 0.91, 95%CI: 0.86-0.96), 9% (OR: 0.91, 95%CI: 0.86-0.96), and 10% (OR: 0.90, 95%CI: 0.85-0.95), respectively. The significant reduced GDM risk was seen in women regardless of age and parity, and slightly stronger effect was found in women whose age ≤ 30 and women who are nulliparous across the three time periods. The significant association was also found in women whose BMI ≤ 24 with similar effect size across the three time periods. Our study suggests that the vitamin nutrient pattern diet is associated with decreased GDM risk. Additional studies are necessary to explore the underlying mechanism of this relationship.
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Affiliation(s)
- Qiong Chen
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
- Office for Cancer Prevention and Research, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou 450008, China
| | - Yongliang Feng
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Hailan Yang
- Department of Obstetrics, The First Affiliated Hospital, Shanxi Medical University, Taiyuan 030001, China
| | - Weiwei Wu
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Ping Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Keke Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Ying Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Jamie Ko
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, 06520 CT, USA
| | - Jiaxin Shen
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Lingling Guo
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Feng Zhao
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Wenqiong Du
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Shouhang Ru
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Suping Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
| | - Yawei Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan 030001, China
- Department of Surgery, Yale University School of Medicine, New Haven 06520, USA
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, 06520 CT, USA
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