Mortality and morbidity in offspring of mothers with diabetes compared with a population group: a Danish cohort study with 8–35 years of follow‐up

Nielsen, Gunnar Lauge; Welinder, Lotte; Johansen, Martin Berg

doi:10.1111/dme.13312

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…Second, we used paternal diabetes as the negative control exposure to explore potential residential confounding or information bias from genetic factors and shared familial factors such as diabetes-related environment, behaviours and hospital contacts. Third, since diabetes is typically preceded by a period of prediabetes, we evaluated the risk of high RE in mothers have a higher risk of being diagnosed with diabetes in the first 25 years of life [31], we excluded offspring with a diabetes diagnosis to examine the association. Eighth, to take into consideration the influence of ICD code changes since 1994, we restricted a sub-analysis to offspring born after 1994.…”

Section: Statistical Analysesmentioning

confidence: 99%

Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study

Liu

et al. 2021

Diabetologia

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Aims/hypothesis We aimed to investigate the associations between maternal diabetes before or during pregnancy and the risk of high refractive error (RE) in offspring until the age of 25 years. Methods This nationwide register-based cohort study comprised 2,470,580 individuals born in 1977-2016. The exposure was maternal diabetes during or before pregnancy (type 1 diabetes, type 2 diabetes and gestational diabetes). Cox regression was used to examine the association between maternal diabetes and the risk of high RE in offspring from birth until the age of 25 years, adjusting for multiple potential confounders. Results During up to 25 years of follow-up, 553 offspring of mothers with diabetes and 19,695 offspring of mothers without diabetes were diagnosed with high RE. Prenatal exposure to maternal diabetes was associated with a 39% increased risk of high RE: HR 1.39 (95% CI 1.28, 1.51), p < 0.001; standardised cumulative incidence in unexposed offspring at 25 years of age 1.18% (95% CI 1.16%, 1.19%); cumulative incidence difference 0.72% (95% CI 0.51%, 0.94%). The elevated risks were observed for hypermetropia (HR 1.37 [95% CI 1.24, 1.51], p < 0.001), myopia (HR 1.34 [95% CI 1.08, 1.66], p = 0.007) and astigmatism (HR 1.58 [95% CI 1.29, 1.92], p < 0.001). The increased risks were more pronounced among offspring of mothers with diabetic complications (HR 2.05 [95% CI 1.60, 2.64], p < 0.001), compared with those of mothers with diabetes but no diabetic complications (HR 1.18 [95% CI 1.02, 1.37], p = 0.030). Conclusions/interpretation Our findings suggest that maternal diabetes during pregnancy is associated with an increased risk of high RE in offspring, in particular among those of mothers with diabetic complications. Early ophthalmological screening should be recommended in offspring of mothers with diabetes diagnosed before or during pregnancy.

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Section: Statistical Analysesmentioning

confidence: 99%

Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study

Liu

et al. 2021

Diabetologia

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“…We report that among LGA neonates delivered by individuals with diabetes, there is a significantly lower mortality. This finding may be secondary to our large sample size, [43] timing of delivery, [44,45] and close follow-up of offspring with maternal medical conditions. [46][47][48] This article is protected by copyright.…”

Section: Discussionmentioning

confidence: 97%

Large for Gestational Age and Adverse Outcomes: Stratified By Diabetes Status

Nazeer,

Chen,

Cornthwaite

et al. 2024

Am J Perinatol

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Objective: To examine the association of adverse outcomes among parturients with large for gestational age (LGA; birth weight > 90th) newborns, stratified by diabetes status. Additionally, we described the temporal trends of adverse outcomes among LGA neonates. Methods: This retrospective cohort study used the U.S. Vital Statistics dataset between 2014-2020. The inclusion criteria were singleton, non-anomalous LGA live births who labored and delivered at 24-41 weeks with known diabetes status. The co-primary outcomes were composite neonatal adverse outcomes of the following: Apgar score < 5 at 5 minutes, assisted ventilation> 6 hours, seizure, or neonatal or infant mortality, and maternal adverse outcomes of the following: maternal transfusion, ruptured uterus, unplanned hysterectomy, admission to intensive care unit or unplanned procedure. Multivariable Poisson regression models were used to estimate adjusted relative risks (aRR) and 95% confidence intervals (CI). Average annual percent change (AAPC) was calculated to assess changes in rates of LGA and morbidity over time. Results: Of 27 million births in seven years, 1,843,467 (6.8%) met the inclusion criteria. While 1,656,888 (89.9%) did not have diabetes 186,579 (10.1%) were with diabetes. Composite neonatal adverse outcomes (aRR 1.57, 95% CI 1.53-1.62) and composite maternal adverse outcomes (aRR 1.37, 95% CI= 1.36-1.38) were significantly higher among individuals with diabetes, compared to those without diabetes. From 2014 to 2020, the LGA rate was stable among people without diabetes. However, there was a downward trend of LGA in people with diabetes (AAPC= -2.4, 95% CI -3.5, -1.4). Conclusion: In pregnancies with LGA newborns, composite neonatal and maternal morbidities were higher in those with diabetes, compared to those without diabetes.

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“…Only 5 children born to women with DIP died during the post-neonatal period resulting in an OR of 3.8 (1.6–9.2). Additionally, two Danish studies have reported on mortality reaching beyond the perinatal period [ 91 , 92 ]. Only the study by Knorr et al in which children born to mothers with type 1 diabetes were followed for one year found an increased mortality during their first year of life, compared to children born to mothers from the background population (Hazard Ratio 2.10, 95% CI 1.33–3.30, p = 0.001) [ 91 ].…”

Section: Longer Term Effects Of Hyperglycemia In Pregnancy On the Off...mentioning

confidence: 99%

“…Only the study by Knorr et al in which children born to mothers with type 1 diabetes were followed for one year found an increased mortality during their first year of life, compared to children born to mothers from the background population (Hazard Ratio 2.10, 95% CI 1.33–3.30, p = 0.001) [ 91 ]. By contrast.another study comprising children of both women with DIP and GDM, found no significant difference in mortality for children born to women with HIP compared to unaffected controls (risk difference 0.09%, 95% CI −0.79–0.98) [ 92 ].…”

Section: Longer Term Effects Of Hyperglycemia In Pregnancy On the Off...mentioning

confidence: 99%

Hyperglycemia in Pregnancy and Women’s Health in the 21st Century

McIntyre

Fuglsang

Kampmann

et al. 2022

IJERPH

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Hyperglycemia is the commonest medical condition affecting pregnancy and its incidence is increasing globally in parallel with the twin epidemics of diabetes and obesity. Both pre-pregnancy diabetes and gestational diabetes are associated with short term pregnancy complications, with the risk of immediate complications generally broadly rising with more severe hyperglycemia. In this article we firstly consider these risks and their optimal management during pregnancy and then broaden our scope to consider the long-term implications of hyperglycemia in pregnancy as it relates to overall maternal and offspring health in a life course perspective.

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Mortality and morbidity in offspring of mothers with diabetes compared with a population group: a Danish cohort study with 8–35 years of follow‐up

Cited by 7 publications

References 19 publications

Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study

Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study

Large for Gestational Age and Adverse Outcomes: Stratified By Diabetes Status

Hyperglycemia in Pregnancy and Women’s Health in the 21st Century

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