Aim

To compare the frequencies and types of congenital heart defects for infants of women without and with pre-gestational diabetes, type 1 and type 2 diabetes (T1DM, T2DM) and to identify risk factors.

Methods

All live births between 2012 and 2020 were screened for maternal diabetes and infant congenital heart defects using the French Medical Information System Program in Medicine, Surgery and Obstetrics database (PMSI-MCO). Incidences of these defects were estimated, and a logistic model evaluated maternal and fetal prognostic risk factors.

Results

Overall, 6,038,703 mothers did not have pre-gestational diabetes (no-diabetes), 23,147 had T1DM, and 14,401 had T2DM. The incidence of infant congenital disease was 6.2% for the no-diabetes group, 8.0%, for women with T1DM, and 8.4% for women with T2DM (P < 0.001); for congenital heart defects, incidences were respectively 0.8%, 3.0% and 2.7% (P < 0.001). In comparison with the no-diabetes group, the odds ratios (95%CI) of coronary heart defects were 2.07 (1.91;2.24) (P < 0.001) for women with T1DM and 2.20 (1.99;2.44) (P < 0.001) for women with T2DM, with no difference between T1DM and T2DM (P = 0.336). cesarian section, small and large for gestational age, and prematurity were also associated with an increased risk of congenital heart defects.

Conclusion

In this study we observed higher incidences of congenital heart defects in infants of women with pre-gestational diabetes compared to women without pre-gestational diabetes, with no difference between women with T1DM or T2DM. These data call for intensifying preconception care and justify systematic cardiac echography in selected fetuses.

中文翻译：

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孕前糖尿病与后代先天性心脏病的风险：法国全国性研究

目的

比较未患和患有孕前糖尿病、1 型和 2 型糖尿病（T1DM、T2DM）的妇女所生婴儿的先天性心脏缺陷的频率和类型，并确定危险因素。

方法

使用法国医学、外科和产科医疗信息系统计划数据库 (PMSI-MCO) 对 2012 年至 2020 年间的所有活产婴儿进行了孕产妇糖尿病和婴儿先天性心脏病筛查。估计了这些缺陷的发生率，并用逻辑模型评估了母体和胎儿的预后危险因素。

结果

总体而言，6,038,703 名母亲没有妊娠前糖尿病（无糖尿病），23,147 名母亲患有 T1DM，14,401 名母亲患有 T2DM。非糖尿病组婴儿先天性疾病发生率为 6.2%，T1DM 女性为 8.0%，T2DM 女性为 8.4%（P < 0.001）；先天性心脏缺陷的发生率分别为0.8%、3.0%和2.7%（P <0.001）。与非糖尿病组相比，T1DM 女性冠心病的比值比 (95%CI) 为 2.07 (1.91;2.24) ( P < 0.001)，T1DM 女性为 2.20 (1.99;2.44) ( P < 0.001)。患有 T2DM 的女性，T1DM 和 T2DM 之间没有差异（P  = 0.336）。剖腹产、小于胎龄、大于胎龄以及早产也与先天性心脏缺陷的风险增加有关。

结论

在这项研究中，我们观察到，与没有孕前糖尿病的女性相比，患有孕前糖尿病的女性婴儿先天性心脏缺陷的发生率更高，而患有 T1DM 或 T2DM 的女性之间没有差异。这些数据要求加强孕前护理，并证明对选定的胎儿进行系统心脏超声检查是合理的。