| Popis: |
Objective: To study the occurrence of major congenital abnormalities in offspring of women with type 1 and type 2 diabetes and investigate the association between glycated haemoglobin (HbA1c) and major congenital malformations. Design: Register-based study Population: All singletons born alive from January 1, 2000–December 31, 2015 in the North Denmark and Central Denmark regions of Denmark and their mothers. Methods: We used data from Danish health registers and the LABKA database. Logistic regression models were used to compute crude and adjusted prevalence odds ratios (cORs and aORs) with 95% confidence intervals (CIs) for major congenital malformations overall and for subtypes, by type of maternal pre-existing diabetes and HbA1c levels. Main Outcome Measures: Major congenital malformations (overall and specific subtypes). Results: Among 314,245 infants included, 2,020 (0.64%) had mothers with type 1 diabetes and 498 (0.16%) had mothers with type 2 diabetes. We found an aOR of 2.9 (95% CI: 2.5, 3.5) and 1.9 (95% CI: 1.3; 2.8) for major malformations for type 1 and type 2 diabetes, respectively. The highest occurrence was for major congenital heart diseases. For both type 1 and type 2 diabetes, the prevalence of major congenital malformations increased with higher levels of maternal HbA1c. Mothers with type 1 diabetes had higher risks than those without diabetes irrespective of HbA1c, and women with HbA1c levels ≥9.5% had 8 times the odds of major congenital malformations [aOR 8.7 (95% CI: 5.4; 14.5)]. Conclusions: The prevalence of major congenital malformations progressively increased with poorer glycemic control during pregnancy. |
