Congenital heart disease in maternal phenylketonuria: Effects of blood phenylalanine and nutrient intake (original) (raw)
The incidence of congenital heart disease was found to be 7.5% from 414 offspring born to women with phenylketonuria in the National Collaborative Study for Maternal Phenylketonuria (MPKU). Nutrient intake was studied in a subset of 22 offspring with congenital heart disease. The infants with congenital heart disease were divided into two groups, those whose mothers consumed greater than 50% of the recommended dietary allowance (RDA) for protein and those who had consumed less than 50% of the RDA for protein during the pregnancy. The subjects were further categorized based on the blood phenylalanine of the mother of less than or greater than 10 mg/dl during the first eight weeks of gestation. All of the women who produced offspring with congenital heart disease had blood phenylalanine concentrations greater than 10 mg/dl during the first eight weeks of gestation. A Fisher's Exact test showed that there were a significantly greater number of offspring born to women who had low protein intake (p ΟΎ 0.0013). Stepwise analysis indicated first trimester variables that discriminate infants with congenital heart disease. These variables included dietary intake of protein, blood phenylalanine from weeks 4-8 of gestation, dietary fat intake, the initial blood phenylalanine concentration, and intake of vitamin B 12 . An Odds ratio showed that intake of vitamin B 12 was a predictor of congenital heart disease among treated women with PKU.