ORLANDO — Women with either gestational or established diabetes were much more likely to deliver an infant with an atrial septal defect than were those with normal glucose control, based on the results of a retrospective, case-control study that included almost 5,000 women.
Women with established diabetes before they became pregnant were nearly 11-fold more likely to give birth to a child with an atrial septal defect (ASD), compared with women without diabetes, Dr. Creighton W. Don and his associates reported in a poster at the annual scientific sessions of the American Heart Association.
Maternal diabetes was previously linked to other types of congenital defects in newborns, but the relationship of ASD with maternal diabetes had not been previously well studied, said Dr. Don, a cardiologist at the University of Washington, Seattle, and his coinvestigators.
They used linked birth certificate and hospital discharge data from all nonfederal hospitals in the Comprehensive Hospital Abstract Reporting System in Washington state during January 1987-December 2005. Cases were live-born singleton infants diagnosed with ASD. Controls were infants born without ASD in the same year.
The incidence of ASD reports in hospitals from eastern Washington seemed unusually high, so those hospitals were excluded and the analysis was limited to hospitals in western Washington.
The analysis also excluded infants born at less than 32 weeks' gestation or less than 2,500 g. This left about 800 cases and 4,000 control infants who were included in a logistic regression analysis. The analysis controlled for several variables, including gestational age, birth weight, maternal age, maternal body mass index, race, and hospital location.
The analysis showed that women with established diabetes were 10.6-fold more likely to give birth to an infant with an ASD than were mothers without diabetes, and that mothers who developed gestational diabetes were threefold more likely to have a child with ASD.
The differences between the case and control rates for both subgroups were statistically significant.
Other factors linked with significant increases in ASD were non-Hispanic black race, which raised the risk 3.9-fold, and maternal age of 35 years or older, which raised the risk 2.5-fold.