Correa Adolfo, Gilboa Suzanne M, Besser Lilah M, Botto Lorenzo D, Moore Cynthia A, Hobbs Charlotte A, Cleves Mario A, Riehle-Colarusso Tiffany J, Waller D Kim, Reece E Albert
Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Am J Obstet Gynecol. 2008 Sep;199(3):237.e1-9. doi: 10.1016/j.ajog.2008.06.028. Epub 2008 Jul 31.
The purpose of this study was to examine associations between diabetes mellitus and 39 birth defects.
This was a multicenter case-control study of mothers of infants who were born with (n = 13,030) and without (n = 4895) birth defects in the National Birth Defects Prevention Study (1997-2003).
Pregestational diabetes mellitus (PGDM) was associated significantly with noncardiac defects (isolated, 7/23 defects; multiples, 13/23 defects) and cardiac defects (isolated, 11/16 defects; multiples, 8/16 defects). Adjusted odds ratios for PGDM and all isolated and multiple defects were 3.17 (95% CI, 2.20-4.99) and 8.62 (95% CI, 5.27-14.10), respectively. Gestational diabetes mellitus (GDM) was associated with fewer noncardiac defects (isolated, 3/23 defects; multiples, 3/23 defects) and cardiac defects (isolated, 3/16 defects; multiples, 2/16 defects). Odds ratios between GDM and all isolated and multiple defects were 1.42 (95% CI, 1.17-1.73) and 1.50 (95% CI, 1.13-2.00), respectively. These associations were limited generally to offspring of women with prepregnancy body mass index > or =25 kg/m(2).
PGDM was associated with a wide range of birth defects; GDM was associated with a limited group of birth defects.
本研究旨在探讨糖尿病与39种出生缺陷之间的关联。
这是一项多中心病例对照研究，研究对象为国家出生缺陷预防研究（1997 - 2003年）中生育有（n = 13,030）和无（n = 4895）出生缺陷婴儿的母亲。
孕前糖尿病（PGDM）与非心脏缺陷（单发，23种缺陷中的7种；多发，23种缺陷中的13种）和心脏缺陷（单发，16种缺陷中的11种；多发，16种缺陷中的8种）显著相关。PGDM与所有单发和多发缺陷的校正比值比分别为3.17（95%可信区间，2.20 - 4.99）和8.62（95%可信区间，5.27 - 14.10）。妊娠期糖尿病（GDM）与较少的非心脏缺陷（单发，23种缺陷中的3种；多发，23种缺陷中的3种）和心脏缺陷（单发，16种缺陷中的3种；多发，16种缺陷中的2种）相关。GDM与所有单发和多发缺陷的比值比分别为1.42（95%可信区间，1.17 - 1.73）和1.50（95%可信区间，1.13 - 2.00）。这些关联一般仅限于孕前体重指数≥25 kg/m²的女性的后代。
PGDM与多种出生缺陷相关；GDM与一组有限的出生缺陷相关。
