Pregestational Diabetes Raises Birth Defect Risk

July 31, 2008

Pregnant women with pregestational diabetes mellitus are more likely than pregnant women with gestational diabetes mellitus to have a child with birth defects, according to a report published online July 31 in the American Journal of Obstetrics & Gynecology.

THURSDAY, July 31 (HealthDay News) -- Pregnant women with pregestational diabetes mellitus are more likely than pregnant women with gestational diabetes mellitus to have a child with birth defects, according to a report published online July 31 in the American Journal of Obstetrics & Gynecology.

Adolfo Correa, M.D., Ph.D., of the Division of Birth Defects and Developmental Disabilities at the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined associations between diabetes mellitus and 39 birth defects by performing a multicenter case-control study of mothers of infants who were born with birth defects (n=13,030) and without birth defects (n=4,895) in the National Birth Defects Prevention Study.

Pregestational diabetes mellitus was associated with both non-cardiac defects and cardiac defects, the researchers report. It was also associated with increased odds of isolated defects (odds ratio 3.17) and multiple defects (OR, 8.62). Gestational diabetes mellitus was associated with fewer non-cardiac defects and cardiac defects with odds ratios for all isolated andmultiple defects of 1.42 and 1.50, respectively. These associations were more common among women with a prepregnancy body mass index of at least 25, the report indicates.

"Given the increasing prevalence of diabetes mellitus among women of childbearing age, the increased risk for type 2 diabetes mellitus after the onset of gestational diabetes mellitus, and the morbidity and mortality rates that are associated with birth defects, the importance of identifying and implementing effective detection, control and prevention strategies for impaired glucose tolerance among women of childbearing age cannot be overstated," the authors conclude.

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