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Diabetes mellitus during pregnancy and the risks for specific birth defects: a population-based case-control study
J E Becerra1, M J Khoury, J F Cordero
1Division of Birth Defects and Developmental Disabilities, Centers for Disease Control, Atlanta, Georgia 30333.
Pediatrics
|January 1, 1990
Summary
Maternal diabetes significantly increases birth defect risks, especially for central nervous system and cardiovascular malformations in infants. Insulin-dependent diabetes poses a higher risk than gestational diabetes requiring insulin.
Area of Science:
- Reproductive Health
- Pediatric Health
- Epidemiology
Background:
- Maternal diabetes mellitus is a known risk factor for congenital anomalies.
- Limited data exist on the specific risks for individual malformations in infants of diabetic mothers.
Purpose of the Study:
- To evaluate the risks for specific malformations in infants born to mothers with diabetes mellitus.
- To compare risks between insulin-dependent diabetes and gestational diabetes mellitus.
Main Methods:
- Population-based case-control study in Atlanta (1968-1980).
- Included 4929 infants with major malformations and 3029 non-malformed controls.
- Frequency matching by race, birth period, and hospital.
Main Results:
- Infants of mothers with insulin-dependent diabetes had a 7.9-fold increased risk for major malformations.
- Significantly elevated risks observed for central nervous system (15.5-fold) and cardiovascular (18.0-fold) defects.
- Infants of gestational diabetic mothers requiring insulin had a 20.6-fold increased risk for cardiovascular defects.
Conclusions:
- Maternal diabetes, particularly insulin-dependent and insulin-requiring gestational diabetes, is associated with substantially increased risks of major congenital malformations.
- Specific malformation types, including CNS and cardiovascular defects, show heightened risks.
- Gestational diabetes not requiring insulin did not show a statistically significant increased risk.