Spectrum of congenital anomalies in pregnancies with pregestational diabetes

Birth Defects Res A Clin Mol Teratol. 2012 Mar;94(3):134-40. doi: 10.1002/bdra.22886. Epub 2012 Feb 28.


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.

MeSH terms

  • Adult
  • Congenital Abnormalities / epidemiology*
  • Congenital Abnormalities / etiology*
  • Congenital Abnormalities / pathology
  • Congenital Microtia
  • Diabetes Mellitus*
  • Ear / abnormalities
  • Europe / epidemiology
  • Female
  • Heart Defects, Congenital / epidemiology
  • Heart Defects, Congenital / etiology
  • Hernia, Umbilical / epidemiology
  • Hernia, Umbilical / etiology
  • Humans
  • Infant, Newborn
  • Live Birth
  • Male
  • Neural Tube Defects / epidemiology
  • Neural Tube Defects / etiology
  • Population Surveillance / methods*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy in Diabetics / epidemiology*
  • Registries
  • Risk Factors
  • Young Adult