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Vascular complications not linked to neonatal congenital anomalies in type 1 diabetes
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Vascular complications may be associated with preeclampsia in pregnant women with type 1 diabetes, but these conditions do not appear to affect the health of offspring, according to findings published in Diabetic Medicine.
“This research is important for women with type 1 diabetes who are pregnant or planning pregnancy and their health care providers,” Sonia Butalia, MD, FRCPC, MSc, assistant professor in the departments of medicine and community health sciences at the University of Calgary in Alberta, Canada, told Endocrine Today. “The incidence and prevalence of type 1 diabetes is increasing so more and more women are entering their reproductive years with this condition. Pregnant women with type 1 diabetes, as with all other expectant mothers, are eager to know as much information as possible about their children and their pregnancy.”
To evaluate whether maternal vascular complications from diabetes are associated with congenital malformations in their offspring, Butalia and colleagues performed an observational retrospective review of data from 232 pregnant women with type 1 diabetes who were consecutively enrolled in tertiary care centers in Calgary, Alberta, from 2006 to 2010. Hospital charts, neonatal ICU databases and electronic medical records were used to collect the data. The researchers were primarily focused on prepregnancy vascular complications related to diabetes, such as retinopathy, nephropathy and hypertension. Congenital malformations, which were categorized as major or minor, included hip dislocation, atrial septa defects, ventricle septal defects, as well as birthmarks, ear tags and torticollis.
In the study population, 21% of women (n = 49) had at least one vascular complication, which indicated that it was a common occurrence in women with type 1 diabetes, according to Butalia. The researchers noted that these women were older (mean age, 31.8 years) and had diabetes longer (mean duration, 20.9 years) than those without vascular complications (mean age, 29.4 years; mean duration, 11.2 years; P < .05). Congenital anomalies occurred at a rate of 27.5% in the cohort, according to the researchers, who noted that the rate was “considerable.”
Preeclampsia occurred more often among the women with vascular complications than those without (12.5% vs. 1.3%; P = .001). However, after review, the researchers found no statistically significant difference in the rate of major congenital anomalies between women with vascular complications (16.2%) and women without (9.2%). Multivariable analysis revealed that there was no association between vascular complications in the mother and congenital malformations in the child (OR = 1.16; 95% CI, 0.46-2.88). Differences in birth weight and rates of large for gestational age, small for gestational age, preterm delivery and perinatal mortality were also not significant.
“Importantly, the information from this study aids health care providers in their counseling with women with type 1 diabetes about the risk of congenital malformations and alerts clinicians to assess for vascular complications, as they are so common,” Butalia said. – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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