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Diabetes mellitus and birth defects

Adolfo Correa1, Suzanne M Gilboa, Lilah M Besser

  • 1Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. acorrea@cdc.gov

American Journal of Obstetrics and Gynecology
|August 5, 2008
PubMed

Insights

Pregestational diabetes mellitus (PGDM) significantly increases the risk of various birth defects. Gestational diabetes mellitus (GDM) is linked to a smaller range of defects, particularly in mothers with a higher prepregnancy BMI.

Area of Science:

  • Reproductive Health
  • Pediatric Health
  • Endocrinology

Background:

  • Maternal diabetes mellitus is a known risk factor for congenital anomalies.
  • Understanding the differential impact of pregestational versus gestational diabetes is crucial for prenatal counseling and risk assessment.

Purpose of the Study:

  • To investigate the association between pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) with a wide spectrum of 39 birth defects.
  • To differentiate the risks associated with PGDM and GDM in relation to isolated and multiple congenital anomalies.

Main Methods:

  • A multicenter case-control study utilizing data from the National Birth Defects Prevention Study (1997-2003).
  • Involved analysis of infants with (n=13,030) and without (n=4,895) birth defects.
  • Statistical analysis included adjusted odds ratios to assess the strength of associations.

Main Results:

  • PGDM showed significant associations with both noncardiac (7/23 isolated, 13/23 multiple) and cardiac defects (11/16 isolated, 8/16 multiple).
  • Adjusted odds ratios for PGDM were 3.17 for isolated and 8.62 for multiple defects.
  • GDM was associated with fewer defects (3/23 noncardiac, 3/16 cardiac), with odds ratios of 1.42 (isolated) and 1.50 (multiple).
  • Associations for both PGDM and GDM were more pronounced in mothers with a prepregnancy BMI ≥ 25 kg/m².

Conclusions:

  • PGDM is linked to a broad range of congenital anomalies, affecting both cardiac and noncardiac structures.
  • GDM is associated with a more limited set of birth defects, with increased risk observed particularly in overweight or obese mothers.
Abstract

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