RT Journal
A1 Carmichael SL, Yang W, Feldkamp M, et al
T1 REduced risks of neural tube defects and orofacial clefts with higher diet quality
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2012
FD February 1
VO 166
IS 2
SP 121
OP 126
DO 10.1001/archpediatrics.2011.185
UL http://dx.doi.org/10.1001/archpediatrics.2011.185
AB Objective 
                  To examine whether better maternal diet quality was associated with reduced risk for selected birth defects.Design 
                  A multicenter, population-based case-control study, the National Birth Defects Prevention Study.Setting 
                  Ten participating centers in the United States.Participants 
                  Eligible subjects' estimated due dates were from October 1997 through December 2005. Telephone interviews were conducted with 72% of case and 67% of control mothers. Analyses included 936 cases with neural tube defects (NTDs), 2475 with orofacial clefts, and 6147 nonmalformed controls.Main Exposures 
                  Food-frequency data were used to calculate the Mediterranean Diet Score (MDS) and Diet Quality Index (DQI), modeled after existing indices.Main Outcome Measure 
                  Adjusted odds ratios (ORs).Results 
                  After covariate adjustment, increasing diet quality based on either index was associated with reduced risks for the birth defects studied. The strongest association was between anencephaly and DQI; the OR for highest vs lowest quartile was 0.49 (95% CI, 0.31-0.75). The ORs for cleft lip with or without cleft palate and cleft palate and DQI were also notable (0.66 [95% CI, 0.54-0.81] and 0.74 [95%CI, 0.56-0.96], respectively).Conclusions 
                  Healthier maternal dietary patterns, as measured by diet quality scores, were associated with reduced risks of NTDs and clefts. These results suggest that dietary approaches could lead to further reduction in risks of major birth defects and complement existing efforts to fortify foods and encourage periconceptional multivitamin use.