title: Spectrum of congenital anomalies in pregnancies with pregestational diabetes.
abstract: BACKGROUND
  Maternal pregestational diabetes is a well-known risk factor for congenital anomalies. This study analyses the spectrum of congenital anomalies associated with maternal diabetes using data from a large European database for the population-based surveillance of congenital anomalies.
  
  
  METHODS
  Data from 18 population-based EUROCAT registries of congenital anomalies in 1990-2005. All malformed cases occurring to mothers with pregestational diabetes (diabetes cases) were compared to all malformed cases in the same registry areas to mothers without diabetes (non-diabetes cases).
  
  
  RESULTS
  There were 669 diabetes cases and 92,976 non diabetes cases. Odds ratios in diabetes pregnancies relative to non-diabetes pregnancies comparing each EUROCAT subgroup to all other non-chromosomal anomalies combined showed significantly increased odds ratios for neural tube defects (anencephaly and encephalocele, but not spina bifida) and several subgroups of congenital heart defects. Other subgroups with significantly increased odds ratios were anotia, omphalocele and bilateral renal agenesis. Frequency of hip dislocation was significantly lower among diabetes (odds ratio 0.15, 95% CI 0.05-0.39) than non-diabetes cases. Multiple congenital anomalies were present in 13.6 % of diabetes cases and 6.1 % of non-diabetes cases. The odds ratio for caudal regression sequence was very high (26.40,95% CI 8.98-77.64), but only 17% of all caudal regression cases resulted from a pregnancy with pregestational diabetes.
  
  
  CONCLUSIONS
  The increased risk of congenital anomalies in pregnancies with pregestational diabetes is related to specific non-chromosomal congenital anomalies and multiple congenital anomalies and not a general increased risk.
authors.affiliation: Hospital Lillebaelt, Kolding, Denmark. ester.garne@slb.regionsyddanmark.dk
authors.forename: Ester
authors.initials: E
authors.lastname: Garne
authors.forename: Maria
authors.initials: M
authors.lastname: Loane
authors.forename: Helen
authors.initials: H
authors.lastname: Dolk
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Barisic
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Addor
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.forename: Marian
authors.initials: M
authors.lastname: Bakker
authors.forename: Elisa
authors.initials: E
authors.lastname: Calzolari
authors.forename: Carlos
authors.initials: C
authors.lastname: Matias Dias
authors.forename: Berenice
authors.initials: B
authors.lastname: Doray
authors.forename: Miriam
authors.initials: M
authors.lastname: Gatt
authors.forename: Kari Klyungsoyr
authors.initials: KK
authors.lastname: Melve
authors.forename: Vera
authors.initials: V
authors.lastname: Nelen
authors.forename: Mary
authors.initials: M
authors.lastname: O'Mahony
authors.forename: Anna
authors.initials: A
authors.lastname: Pierini
authors.forename: Hanitra
authors.initials: H
authors.lastname: Randrianaivo-Ranjatoelina
authors.forename: Judith
authors.initials: J
authors.lastname: Rankin
authors.forename: Anke
authors.initials: A
authors.lastname: Rissmann
authors.forename: David
authors.initials: D
authors.lastname: Tucker
authors.forename: Christine
authors.initials: C
authors.lastname: Verellun-Dumoulin
authors.forename: Awi
authors.initials: A
authors.lastname: Wiesel
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D065817:Congenital Microtia; D003920:Diabetes Mellitus; D004423:Ear / Q000002:abnormalities; D005060:Europe / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000209:etiology; D006554:Hernia, Umbilical / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth; D008297:Male; D009436:Neural Tube Defects / Q000453:epidemiology / Q000209:etiology; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D055815:Young Adult