Diabetes mellitus and drug abuse during pregnancy and the risk for orofacial clefts and related abnormalities

Abstract

Objective: to assessed the prevalence of diabetes mellitus (DM) and drug abuse in mothers of children with orofacial clefts (OFC).Methods: 325 women who had children (0-3y) with clefts were interviewed. Data regarding type of diabetes, use of legal/illegal drugs during pregnancy, waist girth and fasting blood sugar at the first prenatal consult were collected.Results: twenty seven percent of the women had DM, out of these, 89% had gestational DM, 5,5% type 1 DM and 5,5% type 2 DM. The prevalence of DM in mothers of children with OFC was 27%, it is significantly higher than the average Brazilian population which is 7.6% (p<0.01) (OR=4.5, 95%CI=3.5-5.8). Regarding drug abuse during pregnancy, 32% of the mothers used drugs and a significant positive correlation was observed between drug abuse and the occurrence of clefts and other craniofacial anomalies (p=0.028) (OR=2.87; 95%CI=1.1-7.4).Conclusions: DM and drug abuse during pregnancy increases the risk for OFC and related anomalies and early diagnosis of DM and prevention of drug abuse, especially in pregnant women, should be emphasized.

Gestational Diabetes Mellitus and the Development of Cleft Lip / Palate in Newborns

“…Orofacial clefts are defined as structural anomalies due to the abnormal maxillary development during embryogenesis. They represent a lack of continuity of the upper lips, upper alveolar ridge and palate, with a partial or complete effect upon these structures (3,9).…”

“…The environmental factors that are involved in the risk of orofacial clefts include some behaviors during pregnancy and before pregnancy like: alcohol consumption, certain medications and smoking. Supplement intake, eating behavior and their environmental factors including maternal nutritional status (4,10,11), diabetes mellitus (3,8,12) and others have also been associated with the incidence of OFCs (Table 1) (6)(7)(8).…”

“…In the opinion of World Health Organization (WHO), there is an increase in prevalence of metabolic diseases, including obesity, metabolic syndrome and diabetes (1). Several studies observed these metabolic disorders as risk factors for birth defects in women if diagnosed before or during pregnancy (2)(3)(4).…”

Correlation between quality of life and burden of family caregivers of infants with cleft lip and palate

“…This result is probably related to the location of the institution in that state. It is a public hospital recognized by the World Health Organization as a center of excellence for the treatment of craniofacial anomalies and related syndromes and a national and international reference (1,20) .…”

Vias aéreas superiores e desordens respiratórias do sono em indivíduos com fissura labiopalatina e discrepância maxilomandibular: análise por polissonografia, tomografia computadorizada de feixe cônico e fluidodinâmica computacional

“…Na verdade, acredita-se que esta incidência seja maior.Na avaliação global dos grupos, quanto às doenças sistêmicas que acometeram as mães durante o período gestacional, dentre as mais expressivas, a Esse número reduzido de mães que admitiu ter usado drogas ilícitas, provavelmente se deve ao fato de que as entrevistas se davam geralmente nas enfermarias da Maternidade Santa Isabel, do Posto de Saúde ou mesmo no Ambulatório do HRAC. Nos três locais, as mulheres ficavam muito próximas uma das outras, o que poderia causar constrangimento em admitir o uso de tais drogas.Em estudo prévio de nosso grupo de pesquisa(TRINDADE-SUEDAM et al, 2016), o uso de drogas lícitas ou ilícitas foi relatado por 32% das mães de crianças com FLP, contra apenas 6% do presente estudo. O número aumentado do relato do uso de drogas na amostra daquele estudo se deve ao ambiente físico mais privativo no qual foram coletadas as informações, o que, certamente, favoreceu o relato.…”