TABLE 3.
Associations between pregestational type 1 and type 2 diabetes and cardiac birth defects included in the National Birth Defects Prevention Study, 1997–2011
| No diabetes |
Pregestational type 1 diabetes |
Pregestational type 2 diabetes |
|||
|---|---|---|---|---|---|
| All |
All |
All |
|||
| Birth defect | Unexposeda | Type 1 exposeda |
Type 1 OR (95% CI)b |
Type 2 exposeda |
Type 2 OR (95% CI)b |
| Heterotaxy | 307 | 9 | 13.5 (5.7, 29.3) | 11 | 11.8 (5.4, 24.1) |
| Conotruncal defects | |||||
| Truncus arteriosus | 114 | 3 | 11.9 (2.3, 39.9) | 9 | 20.3 (8.7, 44.0) |
| Tetralogy of Fallot | 1,060 | 8 | 3.7 (1.6, 7.9) | 20 | 5.1 (2.8, 9.1) |
| d-TGA | 708 | 9 | 5.5 (2. 5, 11.4) | 4 | 1.8 (0.5, 5.1) |
| DORV-TGA | 174 | 5 | 10.8 (3.4, 27.6) | 3 | 5.5 (1.1, 17.7) |
| Conoventricular septal Defectc,d | 102 | 0 | NC | 6 | 22.6 (7.7, 60.5) |
| Atrioventricular septal defect | 324 | 7 | 9.4 (3.8, 20.7) | 10 | 12.5 (5.7, 25.2) |
| TAPVR | 272 | 2 | NC | 3 | 3.5 (0.7, 11.3) |
| LVOTO defects | |||||
| HLHS | 579 | 1 | NC | 9 | 4.9 (2.1, 10.3) |
| Coarctation of the aorta | 1,047 | 8 | 3.4 (1.4, 7.3) | 16 | 5.4 (2.9, 9.8) |
| Aortic stenosis | 467 | 4 | 3.9 (1.0, 11.3) | 8 | 5.8 (2.4, 12.7) |
| RVOTO defects | |||||
| Pulmonary atresia | 240 | 0 | NC | 6 | 6.0 (2.1, 14.2) |
| Pulmonary valve stenosisc,d | 1,389 | 12 | 3.8 (1.8, 7.8) | 16 | 3.6 (1.9, 6.6) |
| Tricuspid atresia | 160 | 2 | NC | 4 | 8.0 (2.0, 22.7) |
| Ebstein anomaly | 171 | 0 | NC | 1 | NC |
| Septal defects | |||||
| Perimembranous VSDc,d | 1,313 | 14 | 4.6 (2.1, 10.2) | 24 | 5.7 (3.0, 11.0) |
| Muscular VSD | 176 | 0 | NC | 1 | NC |
| Secundum or ASD NOS | 2,680 | 45 | 7.4 (4.4, 12.5) | 55 | 6.4 (4.0, 10.2) |
| Single ventricle | 141 | 3 | 9.6 (1.8, 32.2) | 12 | 29.6 (13.5, 61.7) |
Note: Bold font represents a statistically significant finding; italicized font represents a crude odds ratio.
Abbreviations: ASD, atrial septal defect; CI, confidence interval; DORV-TGA, double outlet right ventricle with transposition of the great arteries; d-TGA, d-transposition of the great arteries; HLHS, hypoplastic left heart syndrome; LVOTO, left ventricular outflow tract obstruction; NC, not calculated; OR, odds ratio; RVOTO, right ventricular outflow tract obstruction; TAPVR, total anomalous pulmonary venous return; VSD, ventricular septal defect.
The pregestational type 1 analysis included 24 exposed and 10,840 unexposed controls. The pregestational type 2 analyses included 34 exposed and 10,840 unexposed controls.
Crude ORs and Fisher's Exact 95% CIs are presented for defects groups with 3–4 exposed cases and are italicized. For defects with ≥5 exposed cases, Firth's penalized likelihood estimates were adjusted for mother's age, race/ethnicity, education, body mass index (weight in kg/height in m), and study center. Estimates are not provided for analyses with <3 exposed cases.
The number of controls differed for the following type 1 birth defect analyses: pulmonary valve stenosis (21 exposed, 10,401 unexposed controls) and perimembranous VSD (14 exposed and 9,792 unexposed controls).
The number of controls differed for the following type 2 birth defect analyses: conoventricular VSD (16 exposed and 6,340 unexposed controls), pulmonary valve stenosis (34 exposed and 10,401 unexposed controls), perimembranous VSD (16 exposed and 6,340 unexposed controls).