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Title: Pregestational Diabetes Increases Risk for Multiple Birth Defects
URL: http://www.pslgroup.com/dg/226A6E.htm
Doctor's Guide
July 30, 2008

ATLANTA -- July 30, 2008 -- Women who receive a diagnosis of diabetes before they become pregnant are 3 to 4 times more likely to have a child with 1 or even multiple birth defects compared with a mother who is not diabetic, according to a study published in the American Journal of Obstetrics and Gynecology.

The article from the National Birth Defects Prevention Study (NBDPS), done by the Centers for Disease Control and Prevention (CDC), shows that pregnant women with pregestational diabetes are more likely than a mother with no diabetes or a mother with gestational diabetes to have a child with various types of individual or multiple birth defects.

The defects include heart defects, defects of the brain and spine, oral clefts, defects of the kidneys and gastrointestinal tract, and limb deficiencies. This study is the first to show the broad range and severity of birth defects associated with types 1 and 2 diabetes.

"The continued association of diabetes with a number of birth defects highlights the importance of increasing the number of women who receive the best possible preconception care, especially for those women diagnosed with diabetes," said lead author Adolfo Correa, MD, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.

"Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects but also to reduce the risk for other health complications for them and their children."

Researchers also found that some of the pregnant women with gestational diabetes were more likely to have a child with birth defects. Because birth defects associated with diabetes are more likely to occur during the first trimester of pregnancy, and before a diagnosis of gestational diabetes is made, the observed associations suggest that some of the mothers with it probably had undiagnosed diabetes before they became pregnant.

Furthermore, the associations of gestational diabetes with various birth defects were noted primarily among women who had prepregnancy obesity, which is a known risk factor for both diabetes and birth defects.

Preconception care also should be considered and promoted for women with prepregnancy obesity to prevent birth defects and reduce the risk for health complications.

The NBDPS was a population-based, case-control study that incorporated data from 9 birth defect centers in the United States (Arkansas, California, Georgia, Iowa, Massachusetts, New York, North Carolina, Texas, and Utah). Researchers gathered information from more than 30,000 participants and used this information to look at key questions on potential causes of birth defects.


SOURCE: US Centers for Disease Control and Prevention

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