Birth defects chances in women increased by Diabetes

Women who have diabetes before becoming pregnant are about three times as likely as other women to have a baby with at least one birth defect, U.S. researchers said on Wednesday.

A variety of different birth defects are associated with mothers who have type 1 diabetes, also called juvenile diabetes, or type 2 diabetes, the most common form of the disease that is linked to obesity, the researchers said.

These included defects of the heart, brain, spine, limbs, kidneys and gastrointestinal tract, penile and ear abnormalities and cleft palate, the researchers wrote in the American Journal of Obstetrics and Gynecology.

"This study documents the fact that diabetes is associated with a wider range of defects than we had been aware of in the past," Dr. Adolfo Correa of the Centers for Disease Control and Prevention, who led the study, said in a telephone interview.

Correa said it appears that the condition called gestational diabetes is not associated with an increased risk of birth defects. This is a short-lived form of diabetes that can appear in a woman during pregnancy, but blood sugar levels usually return to normal shortly after the baby is born.

But Correa said some cases diagnosed as gestational diabetes may actually be type 2 diabetes that simply had gone unrecognized until the pregnancy.

The study involved 13,030 babies born with birth defects around the United States and 4,895 babies without birth defects, and the researchers determined which of the mothers had diabetes before becoming pregnant.

Women with diabetes had triple the risk of having a baby with birth defects than other women, the researchers said.

"Preconception care is not reaching all women with diabetes the way it ought to. And given the increasing prevalence of diabetes, including diabetes among women of reproductive age in this country and in many parts of the world, this is a call to action to the clinical and public health communities to come up with more effective prevention measures," Correa said.

Correa said doctors who know a woman who is pregnant or planning to become pregnant may consider steps including weight control, diet, exercise and medications.

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Premature birth linked to emphysema

Some premature babies may have a higher risk of developing emphysema and other lung problems, Australian researchers said on Tuesday.

A small study of 21 infants born up to four months prematurely in the 1980s and weighing as little as 0.6 kilograms showed that by the time they were young adults all had lung problems, including 84 percent who showed areas of emphysema.

"Larger, controlled, population-based studies are urgently required to fully define and guide the management of adult lung disease with extreme preterm birth," Daniel Chambers of the Prince Charles Hospital and Andrew Wilson of the Princess Margaret and Royal Perth Hospitals in Australia said in the study published in the European Respiratory Journal.

Emphysema is a progressive lung condition in which the walls between the alveoli, or air sacs, lose their ability to stretch and recoil. Smoking is the main cause, although genes also play a role.

The most common symptoms of chronic obstructive pulmonary disease (COPD) -- which include chronic bronchitis and emphysema -- include shortness of breath, coughing and a limited ability to exercise.

Treating COPD, which affects an estimated 210 million people worldwide, is a major market for GlaxoSmithKline's Advair and one AstraZeneca is hoping to cut into with its rival medicine Symbicort.

The young adults in the study were born between 1980 and 1987 and were dependent on supplementary oxygen for more than 28 days during their stay in the hospital.

The researchers said it was surprising that so many of the volunteers had areas of emphysema, and this may be because they were born so prematurely,

With major improvements in neo-natal care helping more babies survive extreme prematurity, the findings mean doctors will have to pay more attention to the birth history of people born so prematurely, as they may be at higher risk of lung disease as they grow up.

The findings also underscore the extra risks of smoking for people who were born prematurely, the researchers said.

"This study reinforces the importance of stopping, or preferably never taking up, cigarette smoking, particularly if there is a history of preterm birth," the researchers wrote.

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