Jeremy M Schraw1, Peter H Langlois2, Philip J Lupo3. 1. Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX. Electronic address: schraw@bcm.edu. 2. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX; Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health Austin Regional Campus, Austin, TX. 3. Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX.
Abstract
PURPOSE: Our objective was to comprehensively evaluate the risk of a broad range of birth defects among offspring of women with diabetes, overall and stratified by pregestational versus gestational diagnosis, using the phenome-wide association (PheWAS) methodology. METHODS: We performed a registry linkage study of all live births (>6,500,000) and birth defects cases (>290,000) in Texas, 1999-2015. We ascertained diabetes from birth and fetal death certificates. We calculated prevalence rate ratios (PRR) for phenotypes with ≥10 cases among exposed offspring (n = 130). RESULTS: Diabetes was associated with the prevalence of any defect (PRR 1.40, 95% confidence interval [CI] 1.38-1.42), multiple defects (PRR 1.86, 95% CI 1.81-1.91), and 60 specific phenotypes, including novel (hypospadias, mitral stenosis) and previously reported phenotypes (renal a-/dysgenesis, spinal anomalies). Pregestational diabetes was a stronger risk factor for any defect (PRR 2.00, 95% CI 1.93-2.07), multiple defects (PRR 3.27, 95% CI 3.11-3.44), and the 60 specific phenotypes evaluated. Gestational diabetes was associated with any defect (PRR 1.21, 95% CI 1.19-1.23) and 47 specific birth defects phenotypes, although associations were weaker than for pregestational diabetes. CONCLUSIONS: The PheWAS is an efficient way to identify risk factors for disease using population-based registry data. Pregestational diabetes is associated with a broader range of phenotypes than previously reported. Because diabetes is diagnosed in 1% of women prior to pregnancy and 6%-9% during pregnancy, our results highlight a significant public health concern.
PURPOSE: Our objective was to comprehensively evaluate the risk of a broad range of birth defects among offspring of women with diabetes, overall and stratified by pregestational versus gestational diagnosis, using the phenome-wide association (PheWAS) methodology. METHODS: We performed a registry linkage study of all live births (>6,500,000) and birth defects cases (>290,000) in Texas, 1999-2015. We ascertained diabetes from birth and fetal death certificates. We calculated prevalence rate ratios (PRR) for phenotypes with ≥10 cases among exposed offspring (n = 130). RESULTS:Diabetes was associated with the prevalence of any defect (PRR 1.40, 95% confidence interval [CI] 1.38-1.42), multiple defects (PRR 1.86, 95% CI 1.81-1.91), and 60 specific phenotypes, including novel (hypospadias, mitral stenosis) and previously reported phenotypes (renal a-/dysgenesis, spinal anomalies). Pregestational diabetes was a stronger risk factor for any defect (PRR 2.00, 95% CI 1.93-2.07), multiple defects (PRR 3.27, 95% CI 3.11-3.44), and the 60 specific phenotypes evaluated. Gestational diabetes was associated with any defect (PRR 1.21, 95% CI 1.19-1.23) and 47 specific birth defects phenotypes, although associations were weaker than for pregestational diabetes. CONCLUSIONS: The PheWAS is an efficient way to identify risk factors for disease using population-based registry data. Pregestational diabetes is associated with a broader range of phenotypes than previously reported. Because diabetes is diagnosed in 1% of women prior to pregnancy and 6%-9% during pregnancy, our results highlight a significant public health concern.
Authors: Meredith S Campbell; Lisa A Bastarache; Sara L Van Driest; Margaret A Adgent; Jeffery A Goldstein; Joern-Hendrik Weitkamp; Meaghan A Ransom; Rolanda L Lister; Elaine L Shelton; Jennifer M S Sucre Journal: Pediatr Res Date: 2022-04-07 Impact factor: 3.953
Authors: Elisa Benavides; Philip J Lupo; Peter H Langlois; Jeremy M Schraw Journal: Int J Environ Res Public Health Date: 2020-09-29 Impact factor: 3.390