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Is there a reduction of congenital abnormalities in the offspring of diabetic pregnant women after folic acid supplementation? A population‐based case‐control study
Author(s) -
Bánhidy Ferenc,
Dakhlaoui Abdallah,
Puhó Erzsébet H.,
Czeizel Andrew A. E.
Publication year - 2011
Publication title -
congenital anomalies
Language(s) - English
Resource type - Journals
eISSN - 1741-4520
pISSN - 0914-3505
DOI - 10.1111/j.1741-4520.2010.00302.x
Subject(s) - offspring , medicine , folic acid supplementation , pregnancy , population , neural tube defect , urinary system , obstetrics , diabetes mellitus , fetus , pediatrics , folic acid , physiology , endocrinology , biology , genetics , environmental health
The objective of the present study was to estimate the preventive effect of folic acid for structural birth defects (i.e. congenital abnormalities [CAs]) in the offspring of pregnant women with diabetes mellitus type 1 (DM‐1). The occurrence of medically recorded DM‐1 in pregnant women who had malformed fetuses/newborns (cases) and delivered healthy babies (controls) with or without folic acid supplementation was compared in the population‐based Hungarian Case‐Control Surveillance System of Congenital Abnormalities. The case group included 22 843 offspring, and there were 79 (0.35%) pregnant women with DM‐1, while the control group comprised of 38 151 newborns, and 88 (0.23%) had mothers with DM‐1. Case mothers with DM‐1 associated with a higher risk of total rate of CAs in their offspring (OR with 95% CI: 1.5, 1.1–2.0) compared to the total rate of CAs in the offspring of non‐diabetic case mothers. This higher risk can be explained by four specific types/groups of CAs: isolated renal a/dysgenesis; obstructive CA of the urinary tract; cardiovascular CAs; and multiple CAs, namely caudal dysplasia sequence. However, there was no higher rate of total CAs in the children of pregnant women with DM‐1 after folic acid supplementation; in addition, neural‐tube defect and renal a/dysgenesis did not occur. However, this benefit cannot be explained by the CA reduction effect of folic acid during the critical period of major CAs. In conclusion, there was a certain reduction in maternal teratogenic effect of DM‐1 after folic acid supplementation during pregnancy, but the explanation of this effect requires further study.