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Research has shown that women's periconceptional diet and use of vitamin supplements can affect risk of birth defects. We investigated whether maternal consumption of nutritional antioxidants was associated with occurrence of transverse limb deficiency (<jats:styled-content style=\"fixed-case\">TLD<\/jats:styled-content>) and longitudinal limb deficiencies (<jats:styled-content style=\"fixed-case\">LLD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed case\u2013control data from mothers and their singleton infants with <jats:styled-content style=\"fixed-case\">TLD<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a0566), <jats:styled-content style=\"fixed-case\">LLD<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a0339), or no malformation (controls; <jats:italic>n<\/jats:italic>\u00a0=\u00a09384) in the National Birth Defects Prevention Study (1997\u20132009). Using a modified food frequency, we estimated usual pre\u2010pregnancy antioxidant consumption by total fruit and vegetable consumption (in grams) grouped into tertiles, and cumulative antioxidant score (ranging from 1 to 10) based on consumption of three antioxidants: beta\u2010carotene, lycopene, and lutein. We estimated odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) adjusted for maternal age, race\/ethnicity, education, smoking, alcohol use, body mass index, and total energy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to women in the lowest tertile of fruit and vegetable consumption, women in the highest tertile were less likely to have infants with <jats:styled-content style=\"fixed-case\">TLD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.74, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.57, 0.96) or <jats:styled-content style=\"fixed-case\">LLD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.82, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.59, 1.13). Compared to the lowest antioxidant consumption score of 1, those with the highest score of 10 had <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s of 0.68 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.48, 0.95) for <jats:styled-content style=\"fixed-case\">TLD<\/jats:styled-content> and 0.77 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.50, 1.17) for <jats:styled-content style=\"fixed-case\">LLD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dietary intake of antioxidants was associated with reduced odds of limb deficiencies. These findings add further evidence for women's periconceptional diet reducing occurrence of some birth defects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12403","type":"journal-article","created":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T16:16:40Z","timestamp":1504541800000},"page":"90-99","source":"Crossref","is-referenced-by-count":10,"title":["Antioxidant Consumption is Associated with Decreased Odds of Congenital Limb Deficiencies"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6925-1444","authenticated-orcid":false,"given":"Nelson D.","family":"Pace","sequence":"first","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania A.","family":"Desrosiers","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan L.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology and Developmental Medicine Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology and Developmental Medicine Stanford University School of Medicine Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Olshan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill 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