European Journal of Epidemiology

, Volume 34, Issue 4, pp 383–396 | Cite as

Intake of sucrose-sweetened soft beverages during pregnancy and risk of congenital heart defects (CHD) in offspring: a Norwegian pregnancy cohort study

  • Maria T. Grønning DaleEmail author
  • Per Magnus
  • Elisabeth Leirgul
  • Henrik Holmstrøm
  • Håkon K. Gjessing
  • Kristoffer Brodwall
  • Margaretha Haugen
  • Camilla Stoltenberg
  • Nina Øyen


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.


Cohort 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.

Author contributions

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

Ethical approval

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.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Maria T. Grønning Dale
    • 1
    • 2
    Email author
  • Per Magnus
    • 3
  • Elisabeth Leirgul
    • 4
    • 5
  • Henrik Holmstrøm
    • 6
    • 7
  • Håkon K. Gjessing
    • 3
    • 4
  • Kristoffer Brodwall
    • 4
    • 8
  • Margaretha Haugen
    • 9
  • Camilla Stoltenberg
    • 4
    • 9
  • Nina Øyen
    • 4
    • 10
  1. 1.Department of Child HealthNorwegian Institute of Public HealthNydalen, OsloNorway
  2. 2.Department of PsychologyUniversity of OsloOsloNorway
  3. 3.Centre for Fertility and HealthNorwegian Institute of Public HealthOsloNorway
  4. 4.Department of Global Public Health and Primary Care, Faculty of MedicineUniversity of BergenBergenNorway
  5. 5.Department of Heart DiseaseHaukeland University HospitalBergenNorway
  6. 6.Division of Pediatric and Adolescent MedicineOslo University HospitalOsloNorway
  7. 7.Institute of Clinical MedicineUniversity of OsloOsloNorway
  8. 8.Department of PediatricsHaukeland University HospitalBergenNorway
  9. 9.Norwegian Institute of Public HealthOsloNorway
  10. 10.Department of Medical GeneticsHaukeland University HospitalBergenNorway

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