Lack of Periconceptional Vitamins or Supplements Containing Folic Acid and Diabetes-associated Birth Defects

OBJECTIVE: To examine the risk of birth defects in relation to lack of use of periconceptional vitamins or supplements containing folic acid and diabetes. STUDY DESIGN: The National Birth Defects Prevention Study (1997–2004), a multicenter, population-based case-control study of birth defects (14,721 case and 5,437 control infants). Cases were categorized into 18 types of heart defects and 26 non-cardiac birth defects. We estimated odds ratios for independent and joint effects of pre-existing diabetes and lack of periconceptional use of vitamins or supplements containing folic acid. RESULTS: The pattern of odds ratios suggested an increased risk of defects associated with diabetes in the absence versus the presence of periconceptional use of vitamins or supplements containing folic acid. CONCLUSIONS: Lack of periconceptional use of vitamins or supplements containing folic acid may be associated with an excess risk for birth defects due to diabetes. Authors: Adolfo CORREA, MD, Suzanne M. GILBOA, PhD, Lorenzo D. BOTTO, MD, Cynthia A. MOORE, MD, Charlotte A. HOBBS, MD, Mario A. CLEVES, PhD, Tiffany J. RIEHLE-COLARUSSO, MD, D. Kim WALLER, PhD, and E. Albert REECE, MD