Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, P.O. Box 12233, Mail Drop A3-05, Durham, NC 27709, USA.
Diabetologia. 2011 Mar;54(3):516-22. doi: 10.1007/s00125-010-2003-6. Epub 2010 Dec 19.
AIMS/HYPOTHESIS: We assessed the effects of type 1 diabetes and type 2 diabetes on fecundability (as manifest by increased time-to-pregnancy [TTP]) in a large cohort of pregnant women.
This study is based on the Norwegian Mother and Child Cohort Study. Members of this large cohort were enrolled early in pregnancy and asked about TTP and other factors. Among the 58,004 women included in the analysis, we identified 221 cases of type 1 diabetes and 88 cases of type 2 diabetes using the Medical Birth Registry of Norway. A logistic analogue of the proportional probability model, a Cox-like discrete-time model, was used to compute fecundability odds ratios (FORs) and 95% CI for type 1 diabetes and type 2 diabetes, adjusted for maternal age and prepregnancy BMI.
Compared with non-diabetic women, the adjusted FOR for women with type 1 diabetes was 0.76 (95% CI 0.64-0.89) and the adjusted FOR for women with type 2 diabetes was 0.64 (95% CI 0.48-0.84). These FORs did not change substantively and remained statistically significant after excluding women with irregular menstrual cycles and accounting for cycle length.
CONCLUSIONS/INTERPRETATION: The results from the present study provide evidence of substantially decreased fecundability for women with type 1 and type 2 diabetes, even among those with a normal menstrual cycle.
目的/假设：我们评估了 1 型糖尿病和 2 型糖尿病对生育能力（表现为妊娠时间延长[TTP]）的影响，这是在一个大型孕妇队列中进行的。
本研究基于挪威母婴队列研究。该大型队列的成员在妊娠早期被招募，并被问及 TTP 和其他因素。在分析中包括的 58004 名妇女中，我们使用挪威医学出生登记处确定了 221 例 1 型糖尿病和 88 例 2 型糖尿病。使用类似于 Cox 的离散时间模型的比例概率模型的逻辑类似物来计算 1 型糖尿病和 2 型糖尿病的生育能力比值比（FOR）和 95％置信区间（CI），并调整了母亲年龄和孕前 BMI。
与非糖尿病女性相比，1 型糖尿病女性调整后的 FOR 为 0.76（95％CI 0.64-0.89），2 型糖尿病女性调整后的 FOR 为 0.64（95％CI 0.48-0.84）。这些 FOR 没有实质性变化，并且在排除月经不规律的女性并考虑周期长度后仍然具有统计学意义。
结论/解释：本研究的结果提供了证据，表明 1 型和 2 型糖尿病女性的生育能力明显下降，即使在月经周期正常的女性中也是如此。
