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. Author manuscript; available in PMC: 2013 Nov 1.
Published in final edited form as: Birth Defects Res A Clin Mol Teratol. 2012 Aug 29;94(11):864–874. doi: 10.1002/bdra.23068

Table 2.

Association Between Anencephaly or Spina Bifida and Maternal Dietary Micronutrient Intake Stratified by Periconceptional Supplement Use, National Birth Defects Prevention Study, 1997–2005

Adjusted Odds Ratiosa (95% confidence intervals)
Anencephaly (n=300b) Spina Bifida (n=654b)
Nutrient Quartilesc Non-users
supplements
(n=142)		 Supplement
users
(n=151)		 Non-users
supplements
(n=312)		 Supplement
users
(n=326)
One-carbon metabolism
Folate DFE (µg DFE)
    <338.16 referent referent referent referent
    338.16–496.15 0.78 (0.48, 1.26) 0.89 (0.57, 1.39) 0.88 (0.62, 1.25) 0.87 (0.63, 1.21)
    496.16–720.06 0.65 (0.38, 1.10) 0.55 (0.33, 0.93) 0.92 (0.64, 1.32) 0.79 (0.56, 1.13)
    >720.06 0.65 (0.37, 1.16) 0.72 (0.41, 1.26) 0.87 (0.58, 1.30) 0.91 (0.61, 1.35)
Methionine (g)
    <1.10 referent referent referent referent
    1.10–1.43 1.02 (0.60, 1.74) 0.99 (0.60, 1.64) 0.69 (0.47, 1.00) 1.01 (0.72, 1.42)
    1.44–1.87 1.11 (0.62, 1.98) 1.12 (0.64, 1.94) 0.91 (0.62, 1.35) 0.78 (0.52, 1.15)
    >1.87 1.44 (0.74, 2.84) 1.09 (0.54, 2.20) 1.23 (0.78, 1.95) 1.02 (0.63, 1.65)
Cysteine (g)
    <0.66 referent referent referent referent
    0.66–0.86 0.97 (0.59, 1.61) 1.15 (0.70, 1.88) 0.76 (0.52, 1.10) 0.85 (0.60, 1.19)
    0.87–1.15 0.95 (0.55, 1.65) 1.12 (0.66, 1.91) 1.27 (0.87, 1.83) 0.76 (0.52, 1.09)
    >1.15 0.98 (0.52, 1.85) 0.84 (0.44, 1.60) 1.30 (0.84, 2.02) 0.76 (0.49, 1.17)
Choline, Total (mg)
    <190.41 referent referent referent referent
    190.41–254.08 0.96 (0.54, 1.69) 0.95 (0.59, 1.54) 0.67 (0.45, 0.99) 0.95 (0.68, 1.33)
    254.09–343.19 1.31 (0.73, 2.34) 0.88 (0.50, 1.53) 0.87 (0.58, 1.30) 0.93 (0.63, 1.37)
    >343.19 1.54 (0.77, 3.07) 0.86 (0.42, 1.77) 1.38 (0.87, 2.20) 0.83 (0.50, 1.38)
Betaine (mg)
    <46.60 referent referent referent referent
    46.60–75.28 0.83 (0.53, 1.30) 1.03 (0.64, 1.64) 0.77 (0.56, 1.07) 1.01 (0.73, 1.40)
    75.29–123.55 0.68 (0.41, 1.11) 1.17 (0.73, 1.88) 0.79 (0.56, 1.11) 0.99 (0.71. 1.39)
    >123.55 0.64 (0.38, 1.09) 0.98 (0.58, 1.66) 0.85 (0.60, 1.21) 0.94 (0.65, 1.35)
Thiamin (mg)
    <0.89 referent referent referent referent
    0.89–1.21 0.57 (0.33, 0.95) 0.79 (0.49, 1.25) 0.80 (0.56, 1.14) 0.75 (0.54, 1.05)
    1.22–1.67 0.74 (0.44, 1.25) 0.69 (0.41, 1.16) 0.84 (0.58, 1.23) 0.79 (0.54, 1.14)
    >1.67 0.47 (0.25, 0.91) 0.52 (0.27, 1.02) 0.77 (0.49, 1.21) 0.80 (0.51, 1.26)
Riboflavin (mg)
    <1.39 referent referent referent referent
    1.39–1.91 0.69 (0.42, 1.13) 0.90 (0.57, 1.44) 0.73 (0.51, 1.04) 0.70 (0.50, 0.97)
    1.92–2.62 0.69 (0.41, 1.18) 0.76 (0.45, 1.29) 0.96 (0.67, 1.38) 0.63 (0.44, 0.91)
    >2.62 0.59 (0.32, 1.11) 0.79 (0.43, 1.47) 0.86 (0.55, 1.33) 0.68 (0.45, 1.05)
Vitamin B6 (mg)
    <1.39 referent referent referent referent
    1.39–1.91 1.29 (0.75, 2.23) 0.97 (0.60, 1.7) 0.86 (0.60, 1.23) 0.86 (0.61, 1.21)
    1.92–2.67 1.40 (0.79, 2.49) 0.95 (0.55, 1.8) 0.81 (0.55, 1.20) 0.97 (0.66, 1.42)
    >2.67 1.16 (0.58, 2.33) 0.80 (0.41, 1.7) 0.91 (0.58, 1.44) 1.09 (0.69, 1.73)
Vitamin B12 (µg)
    < 3.49 referent referent referent referent
    3.49–5.09 1.10 (0.67, 1.83) 0.90 (0.57, 1.42) 0.92 (0.64, 1.31) 0.79 (0.56, 1.09)
    5.10–7.40 0.92 (0.53, 1.59) 0.71 (0.42, 1.20) 1.03 (0.71, 1.49) 0.80 (0.56, 1.14)
    >7.40 0.98 (0.54, 1.78) 0.77 (0.42, 1.40) 1.13 (0.75, 1.69) 0.90 (0.60, 1.36)
Antioxidants
Vitamin C (mg)
    <59.67 referent referent referent referent
    59.67–101.90 0.93 (0.54, 1.59) 1.04 (0.68, 1.59) 0.77 (0.54, 1.08) 0.78 (0.56, 1.07)
    101.91–154.90 1.58 (0.96, 2.61) 0.85 (0.53, 1.37) 0.71 (0.50, 1.02) 1.03 (0.75, 1.42)
    >154.90 1.09 (0.62, 1.91) 0.58 (0.32, 1.05) 0.82 (0.57, 1.19) 0.87 (0.59, 1.28)
Vitamin E (mg)
    <2.86 referent referent referent referent
    2.86–4.13 1.24 (0.72, 2.12) 0.69 (0.44, 1.07) 0.87 (0.62, 1.24) 0.69 (0.50, 0.97)
    4.14–6.09 1.52 (0.88, 2.63) 0.48 (0.28, 0.83) 0.67 (0.45, 0.99) 0.86 (0.61, 1.21)
    >6.09 1.36 (0.73, 2.56) 0.73 (0.42, 1.26) 1.01 (0.66, 1.52) 0.67 (0.44, 1.00)
Others
Alanine (g)
    <2.25 referent referent referent referent
    2.25–2.94 0.82 (0.46, 1.47) 1.19 (0.72, 1.95) 0.60 (0.40, 0.89) 1.03 (0.74, 1.45)
    2.95–3.85 1.49 (0.84, 2.64) 1.19 (0.67, 2.08) 1.05 (0.71, 1.54) 0.77 (0.52, 1.15)
    >3.85 1.79 (0.90, 3.56) 1.15 (0.56, 2.37) 1.32 (0.83, 2.11) 0.96 (0.59, 1.57)
Niacin (mg)
    <13.45 referent referent referent referent
    13.45–17.77 1.04 (0.62, 1.73) 0.96 (0.59, 1.56) 0.91 (0.64, 1.29) 0.93 (0.66, 1.31)
    17.78–23.65 1.06 (0.61, 1.83) 1.05 (0.61, 1.79) 0.91 (0.62, 1.33) 1.00 (0.68, 1.45)
    >23.65 0.84 (0.43, 1.63) 0.70 (0.36, 1.39) 0.88 (0.56, 1.38) 0.88 (0.55, 1.39)
Iron (mg)
    <8.62 referent referent referent referent
    8.62–12.50 0.80 (0.48, 1.36) 0.77 (0.49, 1.22) 0.90 (0.63, 1.29) 0.90 (0.64, 1.25)
    12.51–17.70 0.81 (0.47, 1.39) 0.59 (0.35, 1.00) 0.82 (0.55, 1.20) 0.74 (0.51, 1.08)
    >17.70 0.68 (0.36, 1.29) 0.51 (0.28, 0.96) 0.96 (0.62, 1.47) 1.08 (0.71, 1.63)
Zinc (mg)
    <7.99 referent referent referent referent
    7.99–10.71 0.82 (0.47, 1.41) 1.64 (0.98, 2.75) 0.66 (0.45, 0.97) 0.98 (0.70, 1.38)
    10.72–14.30 0.96 (0.54, 1.70) 1.51 (0.83, 2.74) 0.82 (0.55, 1.21) 0.88 (0.59, 1.32)
    >14.30 0.77 (0.38, 1.56) 1.57 (0.76, 3.23) 0.96 (0.59, 1.54) 1.05 (0.65, 1.70)
Retinol (µg)
    <218.60 referent referent referent referent
    218.60–348.59 0.71 (0.44, 1.15) 0.96 (0.61, 1.51) 0.82 (0.58, 1.16) 0.91 (0.66, 1.25)
    348.60–535.10 0.62 (0.37, 1.04) 0.86 (0.53, 1.38) 0.96 (0.68, 1.35) 0.74 (0.52, 1.04)
    >535.10 0.74 (0.44, 1.23) 0.69 (0.40, 1.21) 0.94 (0.65, 1.36) 0.88 (0.61, 1.29)
Vitamin A, RAE (µg RAE)
    <390.88 referent referent referent referent
    390.88–592.60 0.75 (0.46, 1.25) 0.70 (0.44, 1.12) 0.93 (0.66, 1.30) 0.95 (0.69, 1.30)
    592.61–858.76 1.07 (0.65, 1.75) 0.76 (0.47, 1.22) 0.94 (0.66, 1.35) 0.69 (0.48, 0.98)
    >858.76 0.85 (0.49, 1.48) 0.71 (0.40, 1.23) 1.00 (0.68, 1.46) 0.81 (0.55, 1.20)

Abbreviations: DFE, dietary folate equivalent; RAE, retinol activity equivalent.

a

Adjusted model includes center and log-transformed energy intake.

b

Cases only. For controls: Non-users of supplements (n=2874); Supplement users (n=3288).

c

Quartiles based on daily nutrient intake of control mothers.