6533b829fe1ef96bd1289801

RESEARCH PRODUCT

No major role for periconceptional folic acid use and its interaction with theMTHFR C677Tpolymorphism in the etiology of congenital anorectal malformations

Nadine ZwinkNel RoeleveldCharlotte H. W. WijersHeiko ReutterHeiko ReutterMichael LudwigHan G. BrunnerEkkehart JenetzkyEkkehart JenetzkyCarlo MarcelisCornelius E. J. SlootsMarc H. W. A. WijnenMarkus DraakenPaul M. A. BroensIvo De BlaauwIvo De BlaauwAlice S. BrooksLoes F.m. Van Der ZandenRobert M.w. HofstraIris A.l.m. Van Rooij

subject

GynecologyEmbryologymedicine.medical_specialtyeducation.field_of_studyPregnancybiologybusiness.industryObstetricsPopulationGeneral MedicineOdds ratiomedicine.diseaseConfidence intervalMethylenetetrahydrofolate reductasePediatrics Perinatology and Child HealthPediatric surgerymedicineEtiologybiology.proteinImperforate anuseducationbusinessDevelopmental Biology

description

Background: Both genetic and nongenetic factors are suggested to be involved in the etiology of congenital anorectal malformations (ARM). Maternal periconceptional use of folic acid supplements were inconsistently suggested to play a role in the prevention of ARM. Therefore, we investigated independent associations and interactions of maternal periconceptional folic acid supplement use and the infant and maternal MTHFR (methylenetetrahydrofolate reductase) C677T polymorphisms with the risk of ARM and subgroups of ARM. Methods: A case-control study was conducted among 371 nonsyndromic ARM cases and 714 population-based controls born between 1990 and 2012 using maternal questionnaires and DNA samples from mother and child. Cases were treated for ARM at departments of Pediatric Surgery of the Radboud university medical center, Sophia Children's Hospital-Erasmus MC Rotterdam, and the University Medical Center Groningen in The Netherlands and hospitals throughout Germany. Results: No association with folic acid use was present (odds ratio = 1.1; 95% confidence interval: 0.8-1.4) for ARM as a group. Infant and maternal MTHFR C677T polymorphisms were weakly associated with isolated ARM in particular. Lack of folic acid supplement use in combination with infants or mothers carrying the MTHFR C677T polymorphism did not seem to increase the risk of ARM or subgroups of ARM. The relative excess risks due to interaction did not clearly indicate interaction on an additive scale either. Conclusion: This first study investigating interactions between periconceptional folic acid supplement use and infant and maternal MTHFR C677T polymorphisms in the etiology of ARM did not provide evidence for a role of this gene-environment interaction. Birth Defects Research (Part A) 100:483-492, 2014. (c) 2014 Wiley Periodicals, Inc.

https://doi.org/10.1002/bdra.23256