Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study
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Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study) : A Register-Based Prospective Cohort Study. / Knorr, Sine; Stochholm, Kirstine; Vlachová, Zuzana; Bytoft, Birgitte; Clausen, Tine D; Jensen, Rikke Beck; Juul, Svend; Ovesen, Per; Damm, Peter; Beck-Nielsen, Henning; Jensen, Dorte M; Gravholt, Claus Højbjerg.
In: Diabetes Care, Vol. 38, No. 5, 05.2015, p. 821-6.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Multisystem Morbidity and Mortality in Offspring of Women With Type 1 Diabetes (the EPICOM Study)
T2 - A Register-Based Prospective Cohort Study
AU - Knorr, Sine
AU - Stochholm, Kirstine
AU - Vlachová, Zuzana
AU - Bytoft, Birgitte
AU - Clausen, Tine D
AU - Jensen, Rikke Beck
AU - Juul, Svend
AU - Ovesen, Per
AU - Damm, Peter
AU - Beck-Nielsen, Henning
AU - Jensen, Dorte M
AU - Gravholt, Claus Højbjerg
N1 - © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
PY - 2015/5
Y1 - 2015/5
N2 - OBJECTIVE: This study examined the long-term consequences for offspring born to mothers with pregestational type 1 diabetes regarding mortality, hospital admissions, and medication. We also examined the association between HbA1c levels during pregnancy and mortality and incidence of hospital admissions.RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing mortality, hospital admissions, and use of medication in offspring (n = 1,326) of women with pregestational type 1 diabetes (index children) with matched control subjects (n = 131,884). We also examined the association between HbA1c levels during pregnancy and mortality and the incidence of hospital admissions. Participants were monitored from birth to the age of 13-21 years.RESULTS: Overall mortality was significantly increased for index children (hazard ratio 2.10, 95% CI 1.33-3.30, P = 0.001). The incidence of hospital admissions for index children was significantly increased (incidence rate ratio [IRR] 1.45, 95% CI 1.38-1.53, P < 0.001), and this was the case for all age groups until the age of 15 years. The incidence of hospital admissions among index children was positively associated with maternal HbA1c before pregnancy and in the first trimester. In addition, the overall use of medication was increased in index children (IRR 1.13, 95% CI 1.07-1.19, P < 0.001).CONCLUSIONS: Type 1 diabetes during pregnancy has long-term implications on the health of offspring, with increased mortality, incidence of hospital admissions, and use of medication. Among mothers with type 1 diabetes, glycemic regulation is positively associated with incidence of hospital admissions in offspring.
AB - OBJECTIVE: This study examined the long-term consequences for offspring born to mothers with pregestational type 1 diabetes regarding mortality, hospital admissions, and medication. We also examined the association between HbA1c levels during pregnancy and mortality and incidence of hospital admissions.RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing mortality, hospital admissions, and use of medication in offspring (n = 1,326) of women with pregestational type 1 diabetes (index children) with matched control subjects (n = 131,884). We also examined the association between HbA1c levels during pregnancy and mortality and the incidence of hospital admissions. Participants were monitored from birth to the age of 13-21 years.RESULTS: Overall mortality was significantly increased for index children (hazard ratio 2.10, 95% CI 1.33-3.30, P = 0.001). The incidence of hospital admissions for index children was significantly increased (incidence rate ratio [IRR] 1.45, 95% CI 1.38-1.53, P < 0.001), and this was the case for all age groups until the age of 15 years. The incidence of hospital admissions among index children was positively associated with maternal HbA1c before pregnancy and in the first trimester. In addition, the overall use of medication was increased in index children (IRR 1.13, 95% CI 1.07-1.19, P < 0.001).CONCLUSIONS: Type 1 diabetes during pregnancy has long-term implications on the health of offspring, with increased mortality, incidence of hospital admissions, and use of medication. Among mothers with type 1 diabetes, glycemic regulation is positively associated with incidence of hospital admissions in offspring.
KW - Adolescent
KW - Adult
KW - Blood Glucose
KW - Child
KW - Child, Preschool
KW - Cohort Studies
KW - Diabetes Mellitus, Type 1
KW - Female
KW - Hemoglobin A, Glycosylated
KW - Hospitalization
KW - Humans
KW - Incidence
KW - Infant
KW - Infant, Newborn
KW - Mothers
KW - Pregnancy
KW - Prenatal Exposure Delayed Effects
KW - Prospective Studies
KW - Young Adult
U2 - 10.2337/dc14-2907
DO - 10.2337/dc14-2907
M3 - Journal article
C2 - 25710920
VL - 38
SP - 821
EP - 826
JO - Diabetes Care
JF - Diabetes Care
SN - 0149-5992
IS - 5
ER -
ID: 161579433