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Insulin analogues in pregnancy and specific congenital anomalies: a literature review
Author(s) -
Jong Josta,
Garne Ester,
WenderOzegowska Ewa,
Morgan Margery,
Jongvan den Berg Lolkje T. W.,
Wang Hao
Publication year - 2016
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2730
Subject(s) - medicine , insulin , insulin lispro , protamine , pregnancy , human insulin , offspring , insulin aspart , diabetes mellitus , endocrinology , insulin detemir , obstetrics , insulin glargine , pediatrics , hypoglycemia , biology , genetics , heparin
Summary Insulin analogues are commonly used in pregnant women with diabetes. It is not known if the use of insulin analogues in pregnancy is associated with any higher risk of congenital anomalies in the offspring compared with use of human insulin. We performed a literature search for studies of pregnant women with pregestational diabetes using insulin analogues in the first trimester and information on congenital anomalies. The studies were analysed to compare the congenital anomaly rate among foetuses of mothers using insulin analogues with foetuses of mothers using human insulin. Of 29 studies, we included 1286 foetuses of mothers using short‐acting insulin analogues with 1089 references of mothers using human insulin and 768 foetuses of mothers using long‐acting insulin analogues with 685 references of mothers using long‐acting human insulin (Neutral Protamine Hagedorn). The congenital anomaly rate was 4.84% and 4.29% among the foetuses of mothers using lispro and aspart. For glargine and detemir, the congenital anomaly rate was 2.86% and 3.47%, respectively. No studies on the use of insulin glulisine and degludec in pregnancy were found. There was no statistically significant difference in the congenital anomaly rate among foetuses exposed to insulin analogues (lispro, aspart, glargine or detemir) compared with those exposed to human insulin or Neutral Protamine Hagedorn insulin. The total prevalence of congenital anomalies was not increased for foetuses exposed to insulin analogues. The small samples in the included studies provided insufficient statistical power to identify a moderate increased risk of specific congenital anomalies. Copyright © 2015 John Wiley & Sons, Ltd.