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Table 2 Associations between ARM and maternal use of dietary supplements

From: Maternal drug use and the risk of anorectal malformations: systematic review and meta-analysis

 

Maternal use of dietary supplements

 

Ref.

First author, year

Exposure

ORcrude [95% CI]

ORadj [95% CI]

Adjustment/matching factors

[28]

Zwink, 2016

Folic acid

1.2 [0.54, 2.48]

1.0 [0.29, 3.40]

Adjusted for gender and birth year of the child, maternal age and BMI

Multivitamins

0.5 [0.11, 2.46]

1.2 [0.21, 7.00]

[53]

Zwink and Choinitzki, 2015

Folic acid

0.9 [0.49, 1.55]b

–

–

0.8 [0.39, 1.83]c

–

 

0.9 [0.57, 1.50]a,d

–

 

Iron

0.9 [0.43, 2.05]b

–

 

2.4 [0.62, 10.72]c

–

 

Multivitamins

1.8 [0.61, 5.60]b

–

 

0.5 [0.18, 1.46]c

–

 

1.1 [0.48, 2.36]a,d

–

 

[57]

Gilboa, 2014

Vitamin E

–

1.1 [0.65, 1.74]g

Adjusted for study center and maternal total energy intake, folate intake (dietary folate equivalents), race/ethnicity, age, education, pre-pregnancy body mass index, smoking, alcohol use and use of folic acid supplements

 

1.7 [1.01, 2.72]h

 

1.5 [0.88, 2.51]i

[41]

Wijers, 2014

Folic acid

–

1.1 [0.8, 1.4]j

Adjusted for maternal education

–

1.0 [0.7, 1.5]k

–

1.1 [0.7, 1.6]l

[27]

van Rooij, 2010

Folic acid

1.0 [0.6, 1.7]

–

–

Multivitamins

1.6 [1.0, 2.7]

–

 

[77]

Källén, 2007

Folic acid

0.9 [0.51, 1.69]a

1.0 [0.55, 1.84]

Year of birth, maternal age, parity, maternal smoking, and number of previous miscarriages

[66]

Czeizel, 2004

Folic acid

0.5 [0.17, 1.23]e

–

–

0.4 [0.17, 0.88]f

–

 

Multivitamins

0.2 [0.02, 1.69]

–

 

[69]

Czeizel, 2004

Multivitamins

0.3 [0.01, 2.35]

–

–

[6]

Correa, 2003

Multivitamins

0.9 [0.45, 1.67]

–

–

[51]

Myers, 2001

Folic acid

0.5 [0.29, 0.88]m,n

0.6 [0.33, 1.07]m,n

Maternal age

0.5 [0.24, 1.04]m,o

0.7 [0.31, 1.42]m,o

0.9 [0.28, 2.96]m,p

0.9 [0.27, 3.06]m,p

0.3 [0.05, 1.24]m,q

0.3 [0.05, 1.38]m,q

  1. aNew calculated in this systematic review and meta-analysis
  2. bCompared to patients with isolated esophageal atresia with or without tracheoesophageal fistula
  3. cCompared to patients with the combined phenotype of esophageal atresia with or without tracheoesophageal fistula and anorectal malformation
  4. dCompared to both, patients with isolated esophageal atresia with or without tracheoesophageal fistula and patients with the combined phenotype of esophageal atresia with or without tracheoesophageal fistula and anorectal malformation
  5. eFolic acid supplementation in the first month of gestation
  6. fFolic acid supplementation in the second month of gestation
  7. gDaily total maternal intake of 5.13–7.79 mg
  8. hDaily total maternal intake of 7.80–14.19 mg
  9. iDaily total maternal intake of > 14.19 mg
  10. jAll ARM cases
  11. kIsolated ARM cases only
  12. lARM with other defects
  13. mRisk Ratio (RR)
  14. nAll cases with an anorectal malformation
  15. oAnorectal malformation with no additional external anomalies
  16. pAnorectal malformation with other caudal anomalies
  17. qAnorectal malformation with multiple anomalies
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Orphanet Journal of Rare Diseases

ISSN: 1750-1172