Madleen Lemaitre , Gurvan Bourdon , Amélie Bruandet , Xavier Lenne , Damien Subtil , Thameur Rakza , Anne Vambergue
{"title":"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","authors":"Madleen Lemaitre , Gurvan Bourdon , Amélie Bruandet , Xavier Lenne , Damien Subtil , Thameur Rakza , Anne Vambergue","doi":"10.1016/j.diabet.2023.101446","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>P</em> < 0.001); for congenital heart defects, incidences were respectively 0.8%, 3.0% and 2.7% (<em>P</em> < 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) (<em>P</em> < 0.001) for women with T1DM and 2.20 (1.99;2.44) (<em>P</em> < 0.001) for women with T2DM, with no difference between T1DM and T2DM (<em>P</em> = 0.336). cesarian section, small and large for gestational age, and prematurity were also associated with an increased risk of congenital heart defects.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pre-gestational diabetes and the risk of congenital heart defects in the offspring: A French nationwide study\",\"authors\":\"Madleen Lemaitre , Gurvan Bourdon , Amélie Bruandet , Xavier Lenne , Damien Subtil , Thameur Rakza , Anne Vambergue\",\"doi\":\"10.1016/j.diabet.2023.101446\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>P</em> < 0.001); for congenital heart defects, incidences were respectively 0.8%, 3.0% and 2.7% (<em>P</em> < 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) (<em>P</em> < 0.001) for women with T1DM and 2.20 (1.99;2.44) (<em>P</em> < 0.001) for women with T2DM, with no difference between T1DM and T2DM (<em>P</em> = 0.336). cesarian section, small and large for gestational age, and prematurity were also associated with an increased risk of congenital heart defects.</p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":11334,\"journal\":{\"name\":\"Diabetes & metabolism\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes & metabolism\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1262363623000289\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes & metabolism","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1262363623000289","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Pre-gestational diabetes and the risk of congenital heart defects in the offspring: A French nationwide study
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.
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.
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