Maternal diabetes and congenital anomalies in South Australia 1986-2000: A population-based cohort study
Maternal diabetes and congenital anomalies in South Australia 1986-2000: A population-based cohort study
复制标题
DOI：
10.1002/bdra.20172
复制
发表时间：
2005-09-01
影响因子：
--
通讯作者：
Hiller, JE
中科院分区：
文献类型：
--
作者：
Sharpe, PB;Chan, A;Hiller, JE
背景：这项研究以人口为基础，对1986-2000年间出生的15年间的新生儿进行了队列研究，调查了在南澳大利亚州出生的母亲患有糖尿病的婴儿中先天异常的风险。既往糖尿病、妊娠期糖尿病和糖耐量受损的报告、记录和诊断的不同使得研究之间的比较变得困难。为了比较已发表的研究，需要详细的研究方法和分析方法，以了解可能发生的潜在的混淆、偏见和效果修改。方法：将南澳大利亚州出生缺陷登记处的先天异常数据与南澳大利亚州卫生部妊娠结局统计组的出生数据联系起来。这使得有关先天异常的信息能够与怀孕细节联系起来，包括糖尿病状况。结果：1986~2000年间，既往患有糖尿病、妊娠期糖尿病或糖耐量减低的母亲所生婴儿先天畸形的患病率显著高于总人口，相对危险度分别为2.01(1.66~2.43)和1.19(1.08~1.31)。这一增加的患病率没有因产妇年龄、种族或其他人口统计因素的调整而改变，在研究期间的15年中，比率也没有变化。结论：在母亲患有糖尿病的婴儿中，先天畸形的患病率显著高于母亲。需要进行更大规模的人口研究，以确定涉及哪些异常现象以及如何减少这些异常现象的发生。
BACKGROUND: This study examined the risk of congenital anomalies in infants born in South Australia to women with maternal diabetes in a population-based cohort study of births over a 15-year period, 1986-2000. Differences in the reporting, recording, and diagnosis of preexisting diabetes mellitus, gestational diabetes mellitus, and impaired glucose tolerance make comparisons between studies difficult. In order to compare published research, details of research methods and analytic approaches are required to understand the potential confounding, bias, and effect modification that may occur. METHODS: Data on congenital anomalies from the South Australian Birth Defects Register were linked to birth data from the Pregnancy Outcome Statistics Unit of the South Australian Department of Health. This enabled information on congenital anomalies to be linked to pregnancy details, including diabetes status. RESULTS: Between 1986 and 2000, the prevalence of congenital anomalies in the infants of mothers with preexisting diabetes mellitus, gestational diabetes mellitus, or impaired glucose tolerance was significantly higher than in the total population; relative risk = 2.01 (1.66-2.43) and 1.19 (1.08-1.31), respectively. This increased prevalence was not modified by adjustments for maternal age, ethnicity, or other demographic factors, nor did the rate change over the 15 years of the study period. CONCLUSIONS: The prevalence of congenital anomalies was found to be significantly higher in the infants of mothers with maternal diabetes. Larger population-based studies are needed to determine which anomalies are involved and how their occurrence can be reduced.