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Nutritional Epidemiology

Low Maternal Dietary Intakes of Iron, Magnesium, and Niacin Are Associated with Spina Bifida in the Offspring¹

Pascal M. W. Groenen^*, Iris A. L. M. van Rooij^*, Petronella G. M. Peer^*, Marga C. Ocké, Gerhard A. Zielhuis^* and Régine P. M. Steegers-Theunissen^*,**,2

^* Department of Epidemiology and Biostatistics, University Medical Center, Nijmegen; The National Institute for Public Health and the Environment, Bilthoven; and ^** Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands

²To whom correspondence should be addressed. E-mail: R.Steegers{at}epib.umcn.nl.

Evidence about the preventive effects of nutrients other than folate on the occurrence of spina bifida is scarce. Therefore, the aim of this work was to investigate the role of maternal nutritional intake and the risk of spina bifida in the offspring. In 106 cases and 181 controls, the mothers’ nutrient intakes were obtained by an FFQ 24 mo after conception of the index pregnancy. Energy-adjusted mean nutrient intakes were compared, and odds ratios (OR) and 95% CI were calculated. Although mean nutrient intakes were comparable to the Dutch food consumption survey data, fat, cholesterol, iron, and folate intakes were below the 1998 Dutch Recommended Daily Allowances. Case mothers had significantly lower intakes of plant proteins (7%), polysaccharides (4%), fiber (7%), iron (6%), magnesium (6%), and niacin (4%) than control mothers. Mono- and disaccharide intakes were significantly higher (6%) in the case mothers than in control mothers. The adjusted OR (95% CI) in the lowest quartiles for plant proteins was 5.4 (2.3–12.4), for fiber 3.1 (1.5–6.8), for iron 3.5 (1.4–8.3), for magnesium 1.9 (0.9–4.1), and for niacin 2.5 (1.2–5.2). Mono- and disaccharide and polysaccharide intakes in the highest quartile had ORs (95% CI) of 2.9 (1.4–6.3) and 0.5 (0.3–1.0), respectively. The nutritional intake of Dutch women from food groups containing iron and folate seems to be compromised. Low preconceptional intakes of plant proteins, iron, magnesium, and niacin are associated with a 2- to 5-fold increased risk of spina bifida.

KEY WORDS: • folate • iron • neural tube defects

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