Congenital abnormalities in the offspring of pregnant women with type 1, type 2 and gestational diabetes mellitus: A population-based case-control study
Congenital abnormalities in the offspring of pregnant women with type 1, type 2 and gestational diabetes mellitus: A population-based case-control study
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DOI：
10.1111/j.1741-4520.2010.00275.x
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发表时间：
2010-06-01
影响因子：
1.3
通讯作者：
Czeizel, Andrew E.
中科院分区：
文献类型：
--
作者：
Ferenc Banhidy;Acs, Nandor;Czeizel, Andrew E.
估计1型（DM-1）、2型（DM-2）和妊娠期糖尿病（GDM）孕妇的后代发生结构性出生缺陷（即先天性畸形[CA]）的风险，并检查糖尿病孕妇近期特殊护理在减少DM相关CA方面的疗效。比较了1980-1996年匈牙利先天性先天性畸形病例对照监测系统中有畸形胎儿/新生儿的孕妇（病例）和分娩健康婴儿的孕妇（对照）的医学记录类型糖尿病的发生率。病例组22843例，其中DM-1型79例（0.35%），DM-2型77例（0.34%），GDM型120例（0.53%）。对照组新生儿38151例，DM-1、DM-2和GDM孕妇分别为88例（0.23%）、141例（0.37%）和229例（0.60%）。CA病例的总发生率仅在DM-1组中较高（校正OR，95% CI：1.5，1.1-2.0），并且在四种特定类型/组中较高：孤立性肾动脉/发育不全、尿路梗阻性CA、心血管CA和多发性CA;即尾部发育不良序列。与以往研究相比，本研究中总CA的风险较低，并且CA的DM-1相关谱也不同。DM-2和GDM孕妇的后代患总CA的风险不高。糖尿病孕妇通过适当的围产期和产前护理，可以预防DM-1对母体的致畸作用。
To estimate the risk of structural birth defects (i.e. congenital abnormalities [CA]) in the offspring of pregnant women with type 1 (DM-1), type 2 (DM-2) and gestational diabetes mellitus (GDM) and to check the efficacy of recent specific care of diabetic pregnant women in the reduction of DM-related CA. Comparison was made of the occurrence of medically recorded types of diabetes mellitus in pregnant women who had malformed fetuses/newborns (cases) and who delivered healthy babies (controls) in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. In the case group, which included 22 843 offspring, there were 79 (0.35%) pregnant women with DM-1, 77 (0.34%) pregnant women with DM-2 and 120 (0.53%) pregnant women with GDM. The control group comprised 38 151 newborns, and 88 (0.23%), 141 (0.37%) and 229 (0.60%) pregnant women with DM-1, DM-2 and GDM, respectively. The total rate of cases with CA was higher only in the DM-1 group (adjusted OR with 95% CI: 1.5, 1.1-2.0) and within four specific types/groups: isolated renal a/dysgenesis, obstructive CA of the urinary tract, cardiovascular CA and multiple CA; namely, caudal dysplasia sequence. The risk of total CA was lower in the present study compared to the risk in previous studies and the DM-1-related spectrum of CA was also different. There was no higher risk of total CA in the offspring of pregnant women with DM-2 and GDM. The certain part of maternal teratogenic effect of DM-1 is preventable with appropriate periconceptional and prenatal care of diabetic women.