Intake of sucrose-sweetened soft beverages during pregnancy and risk of congenital heart defects (CHD) in offspring: a Norwegian pregnancy cohort study
Studies report increased risk of congenital heart defects (CHD) in the offspring of mothers with diabetes, where high blood glucose levels might confer the risk. We explored the association between intake of sucrose-sweetened soft beverages during pregnancy and risk of CHD. Prospective cohort data with 88,514 pregnant women participating in the Norwegian Mother and Child Cohort Study was linked with information on infant CHD diagnoses from national health registers and the Cardiovascular Diseases in Norway Project. Risk ratios were estimated by fitting generalized linear models and generalized additive models. The prevalence of children with CHD was 12/1000 in this cohort (1049/88,514). Among these, 201 had severe and 848 had non-severe CHD (patent ductus arteriosus; valvular pulmonary stenosis; ventricular septal defect; atrial septal defect). Only non-severe CHD was associated with sucrose-sweetened soft beverages. The adjusted risk ratios (aRR) for non-severe CHD was 1.30 (95% CI 1.07–1.58) for women who consumed 25–70 ml/day and 1.27 (95% CI 1.06–1.52) for women who consumed ≥ 70 ml/day when compared to those drinking ≤ 25 ml/day. Dose–response analyses revealed an association between the risk of non-severe CHD and the increasing exposure to sucrose-sweetened soft beverages, especially for septal defects with aRR = 1.26 (95% CI 1.07–1.47) per tenfold increase in daily intake dose. The findings persisted after adjustment for maternal diabetes or after excluding mothers with diabetes (n = 19). Fruit juices, cordial beverages and artificial sweeteners showed no associations with CHD. The findings suggest that sucrose-sweetened soft beverages may affect the CHD risk in offspring.
KeywordsCohort study Sugar consumption Pregnancy Congenital heart defect
MTGD has received funding from an unrestricted grant from Oak Foundation, Geneva, Switzerland. The study sponsors were not involved in the study design; analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication. This work was partly supported by the Research Council of Norway through its Centres of Excellence funding scheme, Project No. 262700. Dr. Øyen was funded by grants from Research Council of Norway (190858/V50) and Western Norway Regional Health Authorities (911734). Tatiana Fomina, Department of Global Health and Primary Care, University of Bergen, Norway, did the quality assurance of data and programmed the algorithm that maps congenital heart defects into embryologically-related defect phenotypes. We thank all the participating families in Norway who took part in this cohort study.
MTGD, NØ and PM designed the study. MTGD and HG analyzed the data and MTGD drafted the paper. Authors participated in project meetings at which the analysis plan and data interpretation were discussed. All authors were responsible for interpretation of data and critically revised the article for important intellectual content.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest
Written informed consent was obtained from all participating women, and the study has been approved by the Regional Committee for Ethics in Medical Research and the Data Inspectorate.
- 24.Norwegian Directorate of Health. Utviklingen i norsk kosthold. 2015. Available online at www.helsedirektoratet.no/publikasjoner.
- 26.Imamura F, O’Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ Brit Med J. 2015;351:p.h3576.CrossRefGoogle Scholar
- 31.Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA. Maternal obesity and risk for birth defects. Pediatrics. 2003;111(Supplement 1):1152–8.Google Scholar
- 39.Hagemo PS. BERTE—a database for children with congenital heart defects. Stud Health Technol Inf. 1994;14:98–101.Google Scholar
- 42.Hastie T, Tibshirani R. Generalized additive models. 1st ed. Boca Raton: Chapman & Hall/CRC; 1990.Google Scholar
- 43.R CT. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna. https://www.R-project.org/2017.