{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:52:27Z","timestamp":1792673547839,"version":"4.5.0"},"reference-count":26,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2015,6,12]]},"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate whether better diet quality in mothers is associated with lower risk for major non-syndromic congenital heart defects in their children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Multicentre population-based case\u2013control study, the National Birth Defects Prevention Study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Ten sites in the USA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Mothers of babies with major non-syndromic congenital heart defects (n=9885) and mothers with unaffected babies (n=9468) with estimated date of delivery from 1997 to 2009.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Adjusted ORs for specific major congenital heart defects by quartiles of maternal diet quality in the year before pregnancy, assessed by the Diet Quality Index for pregnancy (DQI-P) and the Mediterranean Diet Score. Quartile 1 (Q1) reflecting the worst diet quality and Q4 the best diet quality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Better diet quality was associated with reduced risk for some conotruncal and atrial septal heart defects. For DQI-P, estimated risks reductions (Q4 vs Q1) for conotruncal defects were 37% for tetralogy of Fallot (OR 0.63, 95% CI 0.49 to 0.80) and 24% overall (OR 0.76, 95% CI 0.64 to 0.91); and for septal defects, 23% for atrial septal defects (OR 0.77, 95% CI 0.63 to 0.94) and 14% overall (OR 0.86, 95% CI 0.75 to 1.00). Risk reductions were weaker or minimal for most other major congenital heart defects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Better diet quality is associated with a reduced occurrence of some conotruncal and septal heart defects. This finding suggests that a reduction in certain cardiac malformations may be an additional benefit of improved maternal diet quality, reinforcing current preconception care recommendations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2014-308013","type":"journal-article","created":{"date-parts":[[2015,8,24]],"date-time":"2015-08-24T21:43:36Z","timestamp":1440452616000},"page":"43-49","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Lower rate of selected congenital heart defects with better maternal diet quality: a population-based study"],"prefix":"10.1136","volume":"101","author":[{"given":"Lorenzo D","family":"Botto","sequence":"first","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Krikov","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan L","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald G","family":"Munger","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Sciences, Utah State University, Logan, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary M","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia L","family":"Feldkamp","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,8,24]]},"reference":[{"key":"2025090514563892000_101.1.43.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.05.059"},{"key":"2025090514563892000_101.1.43.2","doi-asserted-by":"crossref","unstructured":"McCrindle BW . The prevalence of congenital cardiac lesions. In: Freedom RM , Yoo S-J , Mikailian H , eds. The natural and modified history of congenital heart disease. New York: Futura, Blackwell Publishing, 2004:8\u201315.","DOI":"10.1002\/9780470986905.ch2"},{"key":"2025090514563892000_101.1.43.3","unstructured":"Botto LD . Epidemiology and prevention of congenital heart defects. In: Allen HD , Driscoll DJ , Shaddy RE , et al ., eds. Moss and adams\u2019 heart disease in infants, children, and adolescents, including the fetus and young adult. 8th edn. Philadelphia: Lippincott, 2013:577\u2013616."},{"key":"2025090514563892000_101.1.43.4","unstructured":"Boulet S , Grosse SC , Riehle-Colarusso T , et al . Health care costs of congenital heart defects. In: Wyszynski DF , Correa-Villasenor A , Graham TP , eds. Congenital heart defects: from origin to treatment. 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