| Summary: | 碩士 === 中山醫學大學 === 醫療產業科技管理學系碩士班 === 101 === Background：
Several recent studies have demonstrated that the association between gestational diabetes mellitus (GDM) in mothers and the presence of congenital malformations in their offsprings. The results of these studies appear to be in controversial to each other. Very few studies have been conducted locally in Taiwan on the association between gestational diabetes mellitus (GDM) in mothers and the congenital malformations in their offsprings. The database used in this study was a nationally representative.
Objective：
This study is to analyze the congenital malformations and health status of the first offspring of pregnant women with GDM. It is also to analyze the effect of different treatments on pregnant women with GDM as well as the risk of congenital malformations and health status in their first child.
Method：
The data from the year 2004 to 2009 was obtained from the Birth Certificate Application, National Health Insurance Research Database, and the Birth Registration database. From the data obtained, a total of 188798 women who ever delivered newborns were excluded and a further 3356 women were excluded as these women have already been suffering from diabetes prior to pregnancy. The final number for analysis was 19430 pregnant women with GDM. 793 women were on insulin treatment and the remaining 18637 women were on diet control.
Results：
The prevalence of gestational diabetes in Taiwan is about 3% of the total population. Among 19430 pregnant women suffering from GDM; the average age was 31 years old and the average gestational age was 38.3 weeks. The average birth weight of their offspring was 3163g. The results indicate that pregnant women suffering from GDM had a 1.23 times higher risk for total congenital malformations to occur in their offspring when compared with non-diabetes women. Women with GDM when compared to non-diabetes women had a 1.51 times higher risk for ear face and neck defects to occur in their offspring; had a 1.30 times higher risk for congenital heart defects; had a 1.49 times higher risk for urinary bilateral renal agenesis and had a 1.36 times higher risk for limb defects.
Conclusion：
Pregnant women with GDM had higher risk for total congenital malformations in their offspring when compared with non-diabetes women. The birth defects in first offspring of pregnant women with GDM, such as ear face and neck defects, congenital heart defects, urinary bilateral renal agenesis, and limb defects had higher risk than any other birth defects. Pregnant women with GDM who were treated with insulin had higher risk for total congenital malformations in their offspring when compared with pregnant women with GDM who were on diet control. This is especially true in birth defects of nervous system defects, ear face and neck defects, congenital heart defects, respiratory defects, Oro‐facial clefts, urinary bilateral renal agenesis, chromosome abnormality. The results of this study can be used in the related health management policy.
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