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

Luiz André Freire Pimenta,Alceu Sergio Trindade Junior,Carlos Antônio Negrato,Lília Maria Von Kostrisch,Solange Braga Franzolin,Ivy Kiemle Trindade-Suedam

doi:10.1590/1518-8345.0815.2701

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.

Highlights

Diabetes mellitus (DM) is a metabolic disease resulting in hyperglycemia, either because of the low insulin levels or due to insulin resistance
A particular data stands out, 69% of the offspring of mothers who used drugs during pregnancy was born with cleft lip and palate (CLP) associated to other craniofacial anomalies while only 42% of the children was born with the same characteristics from mothers who haven’t used drugs during pregnancy (Table 4)
This difference was statistically significant (p=0.028). It was observed an increased odds of having a child with CLP and with related anomalies among women who used drugs during pregnancy (OR=2.87; 95% CI=1.1-7.4)

Summary

Introduction

Diabetes mellitus (DM) is a metabolic disease resulting in hyperglycemia, either because of the low insulin levels or due to insulin resistance. According to the World Health Organization (WHO) definition, metabolic syndrome is significantly associated with age, physical activity, dyslipidemia, hypertension, treatment with oral antihyperglycemic medication, and HbA1c levels >7%(1). The global prevalence of DM for all ages was estimated to be 8,3% and is projected to almost double in 2035(2), even in low and middle-income countries such as Brazil[3]. Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance initially diagnosed during pregnancy. Author[5] stated that the pregnancies of women who were both obese and diabetic were 3 times as to result in an offspring with a craniofacial defect than were those of nonobese, nondiabetic women, suggesting that obesity and diabetes mellitus contributes in the pathogenesis of congenital anomalies

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