Modification of the association between diabetes and birth defects by obesity, National Birth Defects Prevention Study, 1997–2011

Details

• Alternative Title:
  Birth Defects Res
• Personal Author:
  Tinker, Sarah C. ; Gilboa, Suzanne M. ; Moore, Cynthia A. ; Waller, D. Kim ; Simeone, Regina M. ; Kim, Shin Y. ; Jamieson, Denise J. ; Botto, Lorenzo D. ; Fisher, Sarah C. ; Reefhuis, Jennita
• Corporate Authors:
  National Birth Defects Prevention Study
• Description:
  Background:
  
  Maternal pregestational diabetes and obesity are risk factors for birth defects. Diabetes and obesity often occur together; it is unclear whether their co-occurrence compounds birth defect risk.
  
  Methods:
  
  We analyzed 1997–2011 data on 29,671 cases and 10,963 controls from the National Birth Defects Prevention Study, a multisite case-control study. Mothers self-reported height, pregestational weight, and diabetes (pregestational and gestational; analyzed separately). We created four exposure groups: no obesity or diabetes (referent), obesity only, diabetes only, and both obesity and diabetes. We estimated odds ratios (ORs) using logistic regression and the relative excess risk due to interaction (RERI).
  
  Results:
  
  Among mothers with pregestational obesity without diabetes, modest associations (OR range: 1.1–1.5) were observed for neural tube defects, small intestinal atresia, anorectal atresia, renal agenesis/hypoplasia, omphalocele, and several congenital heart defects. Pregestational diabetes, regardless of obesity, was strongly associated with most birth defects (OR range: 2.0–75.9). Gestational diabetes and obesity had a stronger association than for obesity alone and the RERI (in parentheses) suggested additive interaction for hydrocephaly (1.2; 95% confidence interval [CI]: −0.1, 2.5), tetralogy of Fallot (0.9; 95% CI: −0.01, 1.8), atrioventricular septal defect (1.1; 95% CI: −0.1, 2.3), hypoplastic left heart syndrome (1.1; 95% CI: −0.2, 2.4), and atrial septal defect secundum or not otherwise specified (1.0; 95% CI: 0.3, 1.6; only statistically significant RERI).
  
  Conclusions:
  
  Our results do not support a synergistic relationship between obesity and diabetes for most birth defects examined. However, there are opportunities for prevention by reducing obesity and improving glycemic control among women with pregestational diabetes before conception.
  
  
• Subjects:
  Case-Control Studies Diabetes, Gestational Female Heart Defects, Congenital Humans Obesity Odds Ratio Pregnancy
• Keywords:
  Birth Defect Gestational Diabetes Obesity Pregestational Diabetes Type 1 Diabetes Type 2 Diabetes
• Source:
  Birth Defects Res. 113(14):1084-1097
• Pubmed ID:
  33876578
• Pubmed Central ID:
  PMC10926945
• Document Type:
  Journal Article
• Funding:
  NOFO DD18-001/DD/NCBDD CDC HHSUnited States/ ; FOA DD13-003/DD/NCBDD CDC HHSUnited States/ ; CDP 13-003/HX/HSRD VAUnited States/ ; PA 02081/DD/NCBDD CDC HHSUnited States/ ; PA 96043/DD/NCBDD CDC HHSUnited States/ ; FOA DD09-001/DD/NCBDD CDC HHSUnited States/ ; U01 DD001227/DD/NCBDD CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; EP-D-18-001/EPA/EPAUnited States/
• Volume:
  113
• Issue:
  14
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:066aec1da42e28b4ea5854e7d32b794ce25542e7be9880a0275abcae437bd699
• Download URL:
  https://stacks.cdc.gov/view/cdc/151670/cdc_151670_DS1.pdf
• File Type:
  [PDF - 442.82 KB ]