Authors: Aimee S Parnell Adolfo Correa E Albert Reece
Publish Date: 2017/01/24
Volume: 21, Issue: 5, Pages: 1105-1120
Abstract
Objective Inconsistent findings of associations between gestational diabetes mellitus GDM and birth defects suggest unaccounted confounders may underlie the actual basis for such associations We conducted a systematic review to assess observed associations between GDM and birth defects and the extent to which these could be explained by prepregnancy obesity Methods Using a combination of search terms for GDM and birth defects we searched PubMed Scopus CINAHL and ClinicalTrialsgov for humanbased studies published through September 2013 Studies were eligible for inclusion if they included information on maternal diabetes status method of diagnosis of GDM and assessment of birth defects Twentyfour of 768 potential articles were included We collected information on study design location and period method of determination of diabetes status types of birth defects and measures of association reported Results There was no evidence for consistent association of GDM with birth defects with the exception of a weak association between GDM and congenital heart defects When stratified by maternal prepregnancy BMI an association between GDM and congenital heart defects and between GDM and neural tube defects was evident only in women with both GDM and prepregnancy obesity Conclusions for Practice Our findings suggest reported associations between GDM and birth defects may be due in part to undiagnosed metabolic disorders associated with obesity such as pregestational diabetes mellitus rather than GDM These findings highlight the need for increased efforts for prepregnancy screening for undiagnosed diabetes and awareness of the importance of weight management among women of childbearing age with obesity
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