A marked and parallel increase was seen in both ulcerative colitis and Crohn's disease in both genders during the last 25 years, with a corresponding high prevalence of both diseases.
These data indicate that pre-gestational maternal diabetes is associated with strong teratogenic effects on the kidney, urinary tract, and heart, and strongly associated with multiple congenital abnormalities. We found no material association between diabetes and spinal congenital abnormalities and limb deficiencies.
This study confirmed the orofacial cleft (OFC) inducing effect of phenytoin, carbamazepine, oxytetracycline, and thiethylperazine and suggested a possible association between OFCs and oxprenolol and amoxicillin. However, drugs may have only a limited role in the origin of isolated OFCs.
The indirect teratogenic effect of maternal influenza during pregnancy may be restricted by appropriate medical treatment (e.g., antifever drugs) and periconceptional folic acid supplementation.
To estimate the risk of structural birth defects (i.e. congenital abnormalities [CA]) in the offspring of pregnant women with type 1 (DM-1), type 2 (DM-2) and gestational diabetes mellitus (GDM) and to check the efficacy of recent specific care of diabetic pregnant women in the reduction of DM-related CA. Comparison was made of the occurrence of medically recorded types of diabetes mellitus in pregnant women who had malformed fetuses/newborns (cases) and who delivered healthy babies (controls) in the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. In the case group, which included 22 843 offspring, there were 79 (0.35%) pregnant women with DM-1, 77 (0.34%) pregnant women with DM-2 and 120 (0.53%) pregnant women with GDM. The control group comprised 38 151 newborns, and 88 (0.23%), 141 (0.37%) and 229 (0.60%) pregnant women with DM-1, DM-2 and GDM, respectively. The total rate of cases with CA was higher only in the DM-1 group (adjusted OR with 95% CI: 1.5, 1.1-2.0) and within four specific types/groups: isolated renal a/dysgenesis, obstructive CA of the urinary tract, cardiovascular CA and multiple CA; namely, caudal dysplasia sequence. The risk of total CA was lower in the present study compared to the risk in previous studies and the DM-1-related spectrum of CA was also different. There was no higher risk of total CA in the offspring of pregnant women with DM-2 and GDM. The certain part of maternal teratogenic effect of DM-1 is preventable with appropriate periconceptional and prenatal care of diabetic women.
The use of specified critical periods of different congenital abnormalities seems to be more scientific-based than the previously accepted methods for the evaluation of different exposure time windows. Thus this new and feasible approach is recommended for the controlled epidemiological studies in the future after an international consensus in the specified critical periods of different congenital abnormalities and other methodological issues.
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