Pre-gestational diabetes and the risk of congenital heart defects in the offspring: A French nationwide study

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes & metabolism Pub Date : 2023-07-01 DOI:10.1016/j.diabet.2023.101446

Madleen Lemaitre , Gurvan Bourdon , Amélie Bruandet , Xavier Lenne , Damien Subtil , Thameur Rakza , Anne Vambergue

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Abstract

Aim

To compare the frequencies and types of congenital heart defects for infants of women without and with pre-gestational diabetes, type 1 and type 2 diabetes (T1DM, T2DM) and to identify risk factors.

Methods

All live births between 2012 and 2020 were screened for maternal diabetes and infant congenital heart defects using the French Medical Information System Program in Medicine, Surgery and Obstetrics database (PMSI-MCO). Incidences of these defects were estimated, and a logistic model evaluated maternal and fetal prognostic risk factors.

Results

Overall, 6,038,703 mothers did not have pre-gestational diabetes (no-diabetes), 23,147 had T1DM, and 14,401 had T2DM. The incidence of infant congenital disease was 6.2% for the no-diabetes group, 8.0%, for women with T1DM, and 8.4% for women with T2DM (P < 0.001); for congenital heart defects, incidences were respectively 0.8%, 3.0% and 2.7% (P < 0.001). In comparison with the no-diabetes group, the odds ratios (95%CI) of coronary heart defects were 2.07 (1.91;2.24) (P < 0.001) for women with T1DM and 2.20 (1.99;2.44) (P < 0.001) for women with T2DM, with no difference between T1DM and T2DM (P = 0.336). cesarian section, small and large for gestational age, and prematurity were also associated with an increased risk of congenital heart defects.

Conclusion

In this study we observed higher incidences of congenital heart defects in infants of women with pre-gestational diabetes compared to women without pre-gestational diabetes, with no difference between women with T1DM or T2DM. These data call for intensifying preconception care and justify systematic cardiac echography in selected fetuses.

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妊娠前糖尿病与后代先天性心脏缺陷的风险:一项法国全国性研究

目的比较未患妊娠前糖尿病、1型和2型糖尿病（T1DM、T2DM）的妇女和患有妊娠前糖尿病的妇女的婴儿先天性心脏缺陷的频率和类型，并确定危险因素。方法使用法国医学、外科和产科医学信息系统项目数据库（PMSI-MCO）对2012年至2020年间的所有活产婴儿进行母亲糖尿病和婴儿先天性心脏缺陷筛查。估计了这些缺陷的发生率，并通过逻辑模型评估了孕产妇和胎儿的预后风险因素。结果总体而言，6038703名母亲没有妊娠前糖尿病（无糖尿病），23147名母亲患有T1DM，14401名母亲患有T2DM。无糖尿病组婴儿先天性疾病的发生率为6.2%，T1DM妇女为8.0%，T2DM妇女为8.4%（P<；0.001）；先天性心脏缺陷的发生率分别为0.8%、3.0%和2.7%（P<；0.001）。与非糖尿病组相比，T1DM女性冠心病缺陷的比值比（95%CI）为2.07（1.91；2.24）（P<），T2DM女性为2.20（1.99；2.44）（P＜0.001），T1DM和T2DM之间没有差异（P＝0.336），胎龄大小和早产也与先天性心脏缺陷的风险增加有关。结论在本研究中，我们观察到患有妊娠前糖尿病的女性婴儿先天性心脏缺陷的发生率高于未患妊娠前糖尿病女性，T1DM或T2DM女性之间没有差异。这些数据要求加强孕前护理，并证明所选胎儿的系统心脏超声造影是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.