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Published on: November 20, 2015
Congenital malformations in pregnancies complicated by NIDDM
1Department of Obstetrics, University of Southern California School of Medicine, Los Angeles, USA.
Diabetes Care
|November 1, 1995
Summary
Maternal glycemic control, not the type of diabetes medication, impacts congenital malformations in infants born to mothers with non-insulin-dependent diabetes mellitus (NIDDM). This risk is similar to that seen in insulin-dependent diabetes pregnancies without preconceptional care.
Area of Science:
- Reproductive Medicine
- Endocrinology
- Perinatal Medicine
Background:
- Non-insulin-dependent diabetes mellitus (NIDDM) in pregnancy poses risks for congenital malformations.
- The role of oral hypoglycemic agents in early pregnancy and malformation risk is not fully understood.
- Maternal metabolic control is a known factor in pregnancy complications.
Purpose of the Study:
- To investigate the association between oral hypoglycemic agent use in early pregnancy and congenital malformations in infants of mothers with NIDDM.
- To determine if this association is independent of maternal metabolic control.
- To compare malformation risks across different antidiabetic treatment modalities.
Main Methods:
- Prospective data collection from 332 infants born to mothers with NIDDM.
- Exclusion of pregnancies with preconceptional diabetes care.
- Stepwise logistic regression analysis to identify independent risk factors for congenital malformations.
Main Results:
- Overall, 16.9% of infants had congenital anomalies (11.7% major, 5.1% minor).
- No significant difference in malformation rates was found between diet, insulin, or sulfonylurea treatment groups.
- Maternal HbA1c and age at diabetes onset were independently associated with major malformations; treatment mode was not.
Conclusions:
- NIDDM, without preconceptional care, carries a risk for major congenital anomalies comparable to insulin-dependent diabetes mellitus.
- Infant malformation risk is primarily linked to maternal glycemic control during early pregnancy.
- The mode of antidiabetic therapy during early pregnancy did not influence the risk of congenital anomalies.
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