Birth defects jump when mom needs insulin.
It's well known that babies of certain diabetic women face an increased risk of major birth defects. But new research shows that Type I diabetes -- the insulin-dependent, juvenile-onset form of the disease -- may pose more than double the birth-defect risk cited in previous estimates. The study also adds a new group of diabetics to the at-risk list: women who develop temporary, "gestational" diabetes during pregnancy.
Researchers at the Centers for Disease Control in Atlanta base their new estimates on data for 4,929 babies listed in the Atlanta birth-defects registry and information on 3,029 non-deformed babies matched for race, birth date and hospital. They found that diabetics who didn't need to take insulin had no increased risk over nondiabetics of delivering babies with major birth defects. But when women developed a need for insulin supplementation, their risks climbed dramatically -- to 3.4 times the nondiabetic risk for Type II diabetics and 6.5 times the nondiabetic risk for gestational diabetics. Birth defects among Type I mothers occurred at 7.9 times the rate of nondiabetics, the team reports in the January PEDIATRICS. Previous estimates had placed the risk for Type I diabetics at only two to three times that of nondiabetics.
"We were particularly surprised by the findings for the gestational diabetics," says study leader Jose E. Becerra, because other studies suggested these babies ran no increased risk. "Even more interesting," he says, was the finding that the increased risk among insulin-using gestational diabetics involved only cardiovascular defects. Defects in babies of other diabetics taking insulin showed no such restriction.
Because supplemented insulin does not pass to the fetus, Becerra suspects diabetes-linked birth defects result from the major metabolic changes that create a need for insulin.
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|Date:||Jan 27, 1990|
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