Sine Knorr1, Kirstine Stochholm2, Zuzana Vlachová3, Birgitte Bytoft4, Tine D Clausen5, Rikke Beck Jensen6, Svend Juul7, Per Ovesen8, Peter Damm4, Henning Beck-Nielsen3, Dorte M Jensen3, Claus Højbjerg Gravholt9. 1. Department of Endocrinology and Internal Medicine and Department of Molecular Medicine, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 2. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Endocrinology, Odense University Hospital, Odense, Denmark. 4. Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 5. Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark. 6. Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 7. Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. 8. Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark. 9. Department of Endocrinology and Internal Medicine and Department of Molecular Medicine, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark ch.gravholt@dadlnet.dk.
Abstract
OBJECTIVE: This study examined the long-term consequences for offspring born to mothers with pregestational type 1 diabetes regarding mortality, hospital admissions, and medication. We also examined the association between HbA1c levels during pregnancy and mortality and incidence of hospital admissions. RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing mortality, hospital admissions, and use of medication in offspring (n = 1,326) of women with pregestational type 1 diabetes (index children) with matched control subjects (n = 131,884). We also examined the association between HbA1c levels during pregnancy and mortality and the incidence of hospital admissions. Participants were monitored from birth to the age of 13-21 years. RESULTS: Overall mortality was significantly increased for index children (hazard ratio 2.10, 95% CI 1.33-3.30, P = 0.001). The incidence of hospital admissions for index children was significantly increased (incidence rate ratio [IRR] 1.45, 95% CI 1.38-1.53, P < 0.001), and this was the case for all age groups until the age of 15 years. The incidence of hospital admissions among index children was positively associated with maternal HbA1c before pregnancy and in the first trimester. In addition, the overall use of medication was increased in index children (IRR 1.13, 95% CI 1.07-1.19, P < 0.001). CONCLUSIONS: Type 1 diabetes during pregnancy has long-term implications on the health of offspring, with increased mortality, incidence of hospital admissions, and use of medication. Among mothers with type 1 diabetes, glycemic regulation is positively associated with incidence of hospital admissions in offspring.
OBJECTIVE: This study examined the long-term consequences for offspring born to mothers with pregestational type 1 diabetes regarding mortality, hospital admissions, and medication. We also examined the association between HbA1c levels during pregnancy and mortality and incidence of hospital admissions. RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing mortality, hospital admissions, and use of medication in offspring (n = 1,326) of women with pregestational type 1 diabetes (index children) with matched control subjects (n = 131,884). We also examined the association between HbA1c levels during pregnancy and mortality and the incidence of hospital admissions. Participants were monitored from birth to the age of 13-21 years. RESULTS: Overall mortality was significantly increased for index children (hazard ratio 2.10, 95% CI 1.33-3.30, P = 0.001). The incidence of hospital admissions for index children was significantly increased (incidence rate ratio [IRR] 1.45, 95% CI 1.38-1.53, P < 0.001), and this was the case for all age groups until the age of 15 years. The incidence of hospital admissions among index children was positively associated with maternal HbA1c before pregnancy and in the first trimester. In addition, the overall use of medication was increased in index children (IRR 1.13, 95% CI 1.07-1.19, P < 0.001). CONCLUSIONS:Type 1 diabetes during pregnancy has long-term implications on the health of offspring, with increased mortality, incidence of hospital admissions, and use of medication. Among mothers with type 1 diabetes, glycemic regulation is positively associated with incidence of hospital admissions in offspring.
Authors: Zuzana Vlachová; Birgitte Bytoft; Sine Knorr; Tine D Clausen; Rikke Beck Jensen; Elisabeth R Mathiesen; Kurt Højlund; Per Ovesen; Henning Beck-Nielsen; Claus H Gravholt; Peter Damm; Dorte M Jensen Journal: Diabetologia Date: 2015-04-30 Impact factor: 10.122
Authors: Zuzana Lohse; Sine Knorr; Birgitte Bytoft; Tine D Clausen; Rikke B Jensen; Peter Oturai; Henning Beck-Nielsen; Claus H Gravholt; Peter Damm; Kurt Højlund; Dorte M Jensen Journal: Diabetologia Date: 2017-10-03 Impact factor: 10.122
Authors: Sine Knorr; Svend Juul; Birgitte Bytoft; Zuzana Lohse; Tine D Clausen; Rikke B Jensen; Peter Damm; Henning Beck-Nielsen; Elisabeth R Mathiesen; Dorte M Jensen; Claus H Gravholt Journal: Diabetologia Date: 2018-02-24 Impact factor: 10.122