Author(s): Farrell T, Neale L, Cundy T
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Abstract AIM: To determine the frequency of major congenital anomalies in the offspring of women with gestational diabetes (GDM), classified according to their postpartum glucose tolerance status. METHODS: A prospective study of pregnancies in women with Type 1 diabetes (n = 221), Type 2 diabetes (n = 317) and GDM (n = 1822) between 1985 and 2000 (15 years). Congenital anomalies were detected by antenatal ultrasound or postnatal examination. RESULTS: The frequency of major congenital anomalies in the offspring was 5.9\% (95\% confidence interval (CI) 3.2-9.8) for women with Type 1 diabetes; 4.4\% (95\% CI 2.4-7.3) for women with Type 2 diabetes; and 1.4\% (95\% CI 0.9-2.0) for women with GDM. Two hundred and thirty-seven women with GDM (13\%) had diabetes diagnosed on early (6-week) postpartum glucose tolerance testing. The frequency of major congenital anomalies in their offspring was 4.6\% (95\% CI 2.3-8.2), compared with 0.9\% (95\% CI 0.5-1.5) for the remainder of the GDM group (P < 0.0001). CONCLUSIONS: GDM is not a homogeneous group with regard to the risk of major congenital anomalies. In those with diabetes on early postpartum testing, who are likely to have had unrecognized Type 2 diabetes antedating their pregnancy, the rate of major congenital anomalies is the same as for women with established Type 1 or Type 2 diabetes. In the remainder of the GDM group, the rate does not differ from the non-diabetic background rate.
This article was published in Diabet Med
and referenced in Journal of Metabolic Syndrome