Dietary Quality during Pregnancy and Congenital Heart Defects

Abstract

Limited studies on maternal dietary quality indices and congenital heart defects (CHD) are available. This study aimed to explore the relationship between dietary quality in pregnancy and CHD among the Chinese population. A case-control study was performed in Northwest China, and 474 cases and 948 controls were included. Eligible women waiting for delivery were interviewed to recall diets and other information during pregnancy. Dietary quality was assessed by the Global Diet Quality Score (GDQS) and Mediterranean Diet Score (MDS). Logistic regression models were adopted to evaluate the associations of dietary quality scores with CHD. Pregnant women with higher scores of GDQS and MDS were at a lower risk of fetal CHD, and the adjusted ORs comparing the extreme quartiles were 0.26 (95%CI: 0.16−0.42; Ptrend < 0.001) and 0.53 (95%CI: 0.34−0.83; Ptrend = 0.007), respectively. The inverse associations of GDQS and MDS with CHD appeared to be stronger among women with lower education levels or in rural areas. Maternal GDQS and MDS had good predictive values for fetal CHD, with the areas under the receiver operating characteristic curves close to 0.8. Efforts to improve maternal dietary quality need to be strengthened to decrease the prevalence of CHD among the Chinese population.

Keywords: Global Diet Quality Score; Mediterranean Diet Score; congenital heart defects; dietary quality; pregnancy.

Figure 1

The proportion of women consuming food components in the Mediterranean Diet Score during pregnancy by the median intake levels among cases and controls. MUFA/SFA, monounsaturated-to-saturated fat ratio. Dark shaded bars indicate maternal consumption above the median levels, and light shaded bars indicate maternal consumption equal to or below the median levels. Statistically significant differences were found for the groups of fruits, vegetables, legumes, fish, dairy, nuts, and red and processed meat between cases and controls by the χ² test (all p < 0.05).

Figure 2

The ROC for the Global Diet Quality Score during pregnancy in the prediction of (A) total congenital heart defects, (B) ventricular septal defects, and (C) atrial septal defects. ASD, atrial septal defects; CHD, congenital heart defects; ROC, receiver operating characteristic curves; VSD, ventricular septal defects. The dotted line refers to the reference line, resulting from random selection.

Figure 3

The ROC for the Mediterranean Diet Score during pregnancy in the prediction of (A) total congenital heart defects, (B) ventricular septal defects, and (C) atrial septal defects. ASD, atrial septal defects; CHD, congenital heart defects; ROC, receiver operating characteristic curves; VSD, ventricular septal defects. The dotted line refers to the reference line, resulting from random selection.