Maternal dietary intake of vitamin A during pregnancy was inversely associated with congenital diaphragmatic hernia: the Japan Environment and Children’s Study

AbstractThe pathogenesis of congenital diaphragmatic hernia (CDH) is largely unknown; however, vitamin A seems to play a role in diaphragmatic development. Previous case–control studies reported that maternal dietary vitamin A intake was inversely associated with the risk of CDH. To our knowledge, however, there is no prospective evidence regarding this association. Our aim was to examine whether maternal intake of vitamin A was associated with CDH occurrence. Baseline data, from the Japan nationwide birth cohort study (2011–2014) of 89 658 mothers (mean age at delivery = 31·2 years) who delivered singleton live births, were analysed. We assessed dietary habits using an FFQ focused on the first trimester and estimated the daily intake of total vitamin A (retinol activity equivalents), retinol, provitamin A carotenoids and vegetables. The occurrence of CDH was ascertained from medical records. A total of forty cases of CDH were documented. The adjusted OR of CDH occurrence for the high total vitamin A intake category (median = 468 μg/d) was 0·6 (95 % CI 0·3, 1·2) with reference to the low intake category (230 μg/d). When we restricted to mothers with a prepregnancy BMI of 18·5–24·9 kg/m2, vitamin A intake was inversely associated with the risk of their children being born with CDH (OR 0·5, 95 % CI 0·2, 1·0). Even given the limited number of cases in the study, our findings provide additional evidence to link vitamin A with CDH.

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Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenital diaphragmatic hernia in the offspring

Birth Defects Research Part A Clinical and Molecular Teratology ◽

10.1002/bdra.23093 ◽

2013 ◽

Vol 97 (1) ◽

pp. 60-66 ◽

Cited By ~ 18

Author(s):

Leonardus W. J. E. Beurskens ◽

Lieske H. Schrijver ◽

Dick Tibboel ◽

Mark F. Wildhagen ◽

Maarten F. C. M. Knapen ◽

...

Keyword(s):

Vitamin A ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Daily Intake ◽

Dietary Vitamin

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Low maternal vitamin A intake increases the incidence of teratogen induced congenital diaphragmatic hernia in mice

Pediatric Research ◽

10.1038/s41390-021-01409-6 ◽

2021 ◽

Author(s):

Ayanna W. Rocke ◽

Tianna G. Clarke ◽

Timothy R. A. Dalmer ◽

Sydney A. McCluskey ◽

Juan F. Garcia Rivas ◽

...

Keyword(s):

Risk Factor ◽

Vitamin A ◽

Mouse Model ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Epidemiological Data ◽

Dietary Vitamin ◽

Maternal Vitamin ◽

Retinoid Signaling ◽

Vitamin A Status

Abstract Background Congenital diaphragmatic hernia (CDH) is a severe birth defect associated with high perinatal mortality and long-term morbidity. The etiology of CDH is poorly understood although abnormal retinoid signaling has been proposed to contribute to abnormal diaphragm development. Existing epidemiological data suggest that inadequate dietary vitamin A intake is a risk factor for developing CDH. Methods Using a mouse model of teratogen-induced CDH, the objective of this study was to test the hypothesis that low maternal vitamin A intake contributes to abnormal diaphragm development. To test this hypothesis, we optimized a model of altered maternal dietary vitamin A intake and a teratogenic model of CDH in mice that recapitulates the hallmark features of posterolateral diaphragmatic hernia in humans. Results Our data uniquely show that low maternal dietary vitamin A intake and marginal vitamin A status increases the incidence of teratogen-induced CDH in mice. Conclusion Low dietary vitamin A intake and marginal vitamin A status lead to an increased incidence of teratogen-induced CDH in mice, highlighting the importance of adequate dietary vitamin A intake and CDH risk. Impact This study describes and validates a mouse model of altered maternal and fetal vitamin A status. This study links existing epidemiological data with a mouse model of teratogen-induced congenital diaphragmatic hernia, highlighting the importance of low maternal vitamin A intake as a risk factor for the development of congenital diaphragmatic hernia. This study supports the Retinoid Hypothesis, which posits that the etiology of congenital diaphragmatic hernia is linked to abnormal retinoid signaling in the developing diaphragm.

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P07.02: First trimester diagnosis of congenital diaphragmatic hernia: too good or too bad?

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.9692 ◽

2011 ◽

Vol 38 (S1) ◽

pp. 190-191

Author(s):

R. S. Abu-Rustum ◽

H. Ayoubi ◽

J. Jani

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

First Trimester

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Dietary heterocyclic aromatic amine intake and cancer risk: epidemiological evidence from Japanese studies

Genes and Environment ◽

10.1186/s41021-021-00202-5 ◽

2021 ◽

Vol 43 (1) ◽

Author(s):

Motoki Iwasaki ◽

Shoichiro Tsugane

Keyword(s):

Prostate Cancer ◽

Cancer Risk ◽

Colorectal Adenoma ◽

Dietary Habits ◽

Daily Intake ◽

Epidemiological Studies ◽

Heterocyclic Aromatic Amines ◽

Cooking Methods ◽

Case Control Studies ◽

Significant Positive Association

AbstractHeterocyclic aromatic amines (HAAs), which are formed from the reaction of creatine or creatinine, amino acids, and sugars in meat and fish cooked at high temperatures, have been shown to be mutagenic in bacterial assays and carcinogenic in animal models. Following advances in the dietary assessment of HAA intake in epidemiological studies - including development of a validated meat-cooking module and a specialized food composition database - a number of epidemiological studies have specifically examined the association of HAA intake and cancer risk, most of which were conducted in Western countries. Given that dietary habits and cooking methods differ across countries, however, epidemiological investigation of dietary HAA intake requires a population-specific assessment method. Here, we developed a practical method for assessing dietary HAA intake among Japanese using a food frequency questionnaire (FFQ) and evaluated its validity for use in epidemiological studies by comparison with 2-amino-1-methyl-6-phenylimidazo [4,5-b] pyridine (PhIP) levels in human hair. The Japan Public Health Center-based Prospective Study reported that daily intake of HAAs among Japanese was relatively low, and that more than 50% of total intake in mainland Japan was derived from fish. Only four case-control studies in Japan have been reported so far, for colorectal, stomach and prostate cancer, and colorectal adenoma. A statistically significant positive association was found between 2-amino-3,4-dimethylimidazo [4,5-f] quinoline (MeIQ) and the risk of colorectal adenoma and between individual and total HAAs and the risk of prostate cancer. In contrast, no association was observed for colorectal or stomach cancer, or for colorectal adenoma among men. We also found that the limited and inconsistent findings among epidemiological studies are due to the difficulty in assessing exposure levels of HAAs. In addition to further evidence from prospective cohort studies in Japanese based on dietary HAA intake estimated by FFQs, studies using other methods to assess HAA exposure, such as biomarkers, are highly anticipated.

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Restoring Effects of Vitamin A on Surfactant Synthesis in Nitrofen-induced Congenital Diaphragmatic Hernia in Rats

American Journal of Respiratory and Critical Care Medicine ◽

10.1164/ajrccm.164.6.2010115 ◽

2001 ◽

Vol 164 (6) ◽

pp. 1083-1089 ◽

Cited By ~ 54

Author(s):

BERNARD THÉBAUD ◽

ANNE-MARIE BARLIER-MUR ◽

BERNADETTE CHAILLEY-HEU ◽

ALEXANDRA HENRION-CAUDE ◽

DICK TIBBOEL ◽

...

Keyword(s):

Vitamin A ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Surfactant Synthesis

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Congenital diaphragmatic hernia in a first-trimester ultrasound aneuploidy screening program

Prenatal Diagnosis ◽

10.1002/pd.2019 ◽

2008 ◽

Vol 28 (6) ◽

pp. 531-534 ◽

Cited By ~ 7

Author(s):

Waldo Sepulveda ◽

Amy E. Wong ◽

Alexandra Casasbuenas ◽

Aldo Solari ◽

Juan L. Alcalde

Keyword(s):

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Screening Program ◽

First Trimester ◽

Aneuploidy Screening ◽

First Trimester Ultrasound

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Antenatal vitamin A administration attenuates lung hypoplasia by interfering with early instead of late determinants of lung underdevelopment in congenital diaphragmatic hernia

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2005.01.034 ◽

2005 ◽

Vol 40 (4) ◽

pp. 658-665 ◽

Cited By ~ 27

Author(s):

Maria J. Baptista ◽

Gustavo Melo-Rocha ◽

Carla Pedrosa ◽

Sílvia Gonzaga ◽

Antónia Teles ◽

...

Keyword(s):

Vitamin A ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Lung Hypoplasia

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Vitamin A decreases the incidence and severity of nitrofen-induced congenital diaphragmatic hernia in rats

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.1999.277.2.l423 ◽

1999 ◽

Vol 277 (2) ◽

pp. L423-L429 ◽

Cited By ~ 16

Author(s):

Bernard Thébaud ◽

Dick Tibboel ◽

Caroline Rambaud ◽

Jean-Christophe Mercier ◽

Jacques R. Bourbon ◽

...

Keyword(s):

Vitamin A ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Weight Ratio ◽

Treated Group ◽

Control Group ◽

Lung Growth ◽

Body Weight Ratio ◽

Pregnant Rats ◽

Antenatal Treatment

Congenital diaphragmatic hernia (CDH) is a major cause of refractory respiratory failure in the newborn. Pulmonary hypoplasia often limits survival. Vitamin A (Vit A) is an important signal for lung growth. We hypothesized that antenatal treatment with Vit A would stimulate lung growth and decrease mortality in experimental CDH induced in rats by ingestion of the herbicide nitrofen (2,4-dichlorophenyl- p-nitrophenyl ether). Nitrofen was administered to pregnant rats on day 12 of gestation (term 22 days). Rats were assigned to five groups: three groups received one dose of oral antenatal Vit A (15,000 IU) before ( day 10), concomitant with ( day 12), or after ( day 14) nitrofen administration; one group received only nitrofen; and a control group received vehicle (olive oil). The incidence of CDH was markedly lower in all groups receiving Vit A ( day 10, 44%; day 12, 20%; and day 14, 40%) compared with the nitrofen-treated group (84%; P < 0.05). The 72-h survival was higher in all 3 Vit A-treated groups ( day 10, 40%; day 12, 58%; and day 14, 70%) compared with the nitrofen-treated group (16%; P< 0.05). Lung-to-body weight ratio and radial saccular count were significantly increased by Vit A. Antenatal treatment with Vit A lowers the incidence and severity of experimental CDH and increases lung growth and maturation.

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