Association between mothers' nutrient intake and their offspring's risk ofgastroschisis

The young age of mothers of infants with gastroschisis, a congenital defect of the abdominal wall, suggested that deficient nutrition, with maternal-f etal competition for nutrients, could be a risk factor for gastroschisis. T his population-based hypothesis-generating study consisted of 55 cases of g astroschisis and 182 matched controls. We assessed maternal nutrient intake during the trimester before conception with a self-reported food-frequency questionnaire and screened 38 nutrients to identify those most likely to b e associated with gastroschisis. We used statistical classification trees t o empirically generate cutpoints that determined the low and high levels of nutrient intakes corresponding to the risk of gastroschisis; cutpoints for most nutrients were similar to the corresponding recommended daily dietary allowances (RDAs), In univariate analysis, low intake of several nutrients emerged as the leading risk factors: carotenoids, e.g., alpha-carotene (od ds ratio (OR) = 4.6; 95% confidence interval (CI) = 2.2-9.5), beta-carotene (OR = 3.1; 95% CI = 1.6-6.0); amino-acid compounds, e.g., total glutathion e (OR = 3.5; 95% CI = 1.7-7.2); vitamin C (OR = 2.2; 95% CI = 1.5-7.8); vit amin E (OR = 2.3; 95% CI = 1.2-4.4); and minerals, fiber, and the fruit-and -vegetable group (OR = 3.1; 95% CI = 1.5-6.2), High intake of nitrosamines (OR = 2.4; 95% CI = 1.3-4.5) was also a good candidate. Many nutrient value s were correlated and, in multivariate analysis, those most associated with gastroschisis were low alpha-carotene (OR = 4.3; 95% CI = 1.9-9.8), low to tal glutathione (OR = 3.3; 95% CI = 1.4-7.6), and high nitrosamines (OR = 2 .6; 95% CI = 1.3-5.4). Adjusting for variables associated with gastroschisi s in previous analyses of this population did not substantially alter those risks. These results suggest that maternal dietary inadequacy may be a ris k factor for gastroschisis, and the three nutrients that emerged from the n utrient screening appear to be the best candidates to examine in further ep idemiological analyses or biological studies. (C) 1998 Wiley-Liss, Inc.