High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring

H.P.M. Smedts, J.H.M. de Vries, M. Rakhshandehroo, M.F. Wildhagen, A.C. Verkleij-Hagoort, E.A.P. Steegers, R.P.M. Steegers-Theunissen

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39 Citations (Scopus)


Objective To study associations between maternal dietary and supplement intake of antioxidants vitamin E, retinol and congenital heart defects (CHDs). Design Case–control study. Setting Erasmus MC, University Medical Center Rotterdam, the Netherlands. Population Participants were 276 case mothers of a child with CHD and 324 control mothers with their children. Methods Food frequency questionnaires covering the intake of the previous 4 weeks were filled out at 16 months after the index pregnancy. Data were compared between cases and controls using the Mann–Whitney U test. Risk estimates for the association between CHD and dietary intake of vitamin E and retinol were estimated in a multivariable logistic regression model. Main outcome measures Medians (5–95th percentile) and odds ratios with 95% CI. Results Dietary vitamin E intake was higher in case mothers than in controls, 13.3 (8.1–20.4) and 12.6 (8.5–19.8) mg/day (P= 0.05). CHD risk increased with rising dietary vitamin E intakes (P-trend = 0.01). Periconception use of vitamin E supplements in addition to a high dietary vitamin E intake above 14.9 mg/day up to nine-fold increased CHD risk. Retinol intakes were not significantly different between the groups and not associated with CHD risk. Conclusions High maternal vitamin E by diet and supplements is associated with an increased risk of CHD offspring
Original languageEnglish
Pages (from-to)416-423
JournalBJOG : an international journal of obstetrics and gynaecology
Issue number3
Publication statusPublished - 2009


  • oxidative stress
  • homocysteine metabolism
  • diabetic embryopathy
  • energy-intake
  • risk
  • pregnancy
  • antioxidant
  • prooxidant
  • biomarkers
  • disease


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