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Higher diet quality reduces risks of neural tube defects and orofacial clefts
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  • Corporate Authors:
    National Birth Defects Prevention Study
  • Pubmed ID:
  • Pubmed Central ID:
  • Description:

    To examine whether better maternal diet quality was associated with reduced risk for selected birth defects.


    A multi-center, population-based case-control study, the National Birth Defects Prevention Study.


    Ten participating centers in the United States.


    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), 2,475 with orofacial clefts, and 6,147 non-malformed 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 measures

    Adjusted odds ratios.


    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 odds ratio (OR) for highest versus lowest quartile was 0.49 (95% CI 0.31, 0.75). ORs for cleft lip+/−cleft palate and cleft palate and DQI were also notable, with ORs = 0.66 (0.54, 0.81) and 0.74 (0.56, 0.96), respectively.


    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.

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  • Collection(s):
  • Funding:
    1U01-DD-0006982/DD/NCBDD CDC HHS/United States
    6U01-DD-000489/DD/NCBDD CDC HHS/United States
    R01 NS050249/NS/NINDS NIH HHS/United States
    R01 NS050249/NS/NINDS NIH HHS/United States
    R03 DE020112/DE/NIDCR NIH HHS/United States
    R03DE020112/DE/NIDCR NIH HHS/United States
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