Published:
Health Promotion and Chronic Disease Prevention Branch (HPCDP) Public Health Agency of Canada, 2015
Published in:
Health Promotion and Chronic Disease Prevention in Canada, 35 (2015) 5, Seite 79-84
Language:
English
DOI:
10.24095/hpcdp.35.5.01
ISSN:
2368-738X
Origination:
Footnote:
Description:
Objective To examine the impact of pre-pregnancy diabetes mellitus (DM) on thepopulation birth prevalence of congenital anomalies in Canada.
Methods We carried out a population-based study of all women who delivered inCanadian hospitals (except those in the province of Quebec) between April 2002 andMarch 2013 and their live-born infants with a birth weight of 500 grams or more and/or agestational age of 22 weeks or more. Pre-pregnancy type 1 or type 2 DM was identifiedusing ICD-10 diagnostic codes. The association between DM and all congenital anomaliesas well as specific congenital anomaly categories was estimated using adjusted oddsratios; the impact was calculated as a population attributable risk percent (PAR%).
Results There were 118 892 infants with a congenital anomaly among 2 839 680 livebirths (41.9 per 1000). While the prevalence of any congenital anomaly declined from50.7 per 1000 live births in 2002/03 to 41.5 per 1000 in 2012/13, the corresponding PAR%for a congenital anomaly related to pre-pregnancy DM rose from 0.6% (95% confidenceinterval [CI]: 0.4–0.8) to 1.2% (95% CI: 0.9–1.4). Specifically, the PAR% for congenitalcardiovascular defects increased from 2.3% (95% CI: 1.7–2.9) to 4.2% (95%CI: 3.5–4.9) and for gastrointestinal defects from 0.8% (95% CI: 0.2–1.9) to 1.4%(95% CI: 0.7–2.6) over the study period.
Conclusion Although there has been a relative decline in the prevalence of congenitalanomalies in Canada, the proportion of congenital anomalies due to maternal prepregnancyDM has increased. Enhancement of preconception care initiatives for womenwith DM is recommended.