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

BJOG. 2009 Feb;116(3):416-23. doi: 10.1111/j.1471-0528.2008.01957.x.


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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antioxidants / administration & dosage
  • Antioxidants / adverse effects*
  • Case-Control Studies
  • Dietary Supplements / adverse effects*
  • Female
  • Heart Defects, Congenital / chemically induced*
  • Humans
  • Maternal Nutritional Physiological Phenomena / physiology*
  • Preconception Care
  • Pregnancy
  • Risk Factors
  • Vitamin E / administration & dosage
  • Vitamin E / adverse effects*
  • Young Adult


  • Antioxidants
  • Vitamin E