Diabetes and congenital heart defects: a systematic review, meta-analysis, and modeling project.

摘要: Context Maternal pregestational diabetes (PGDM) is a risk factor for development of congenital heart defects (CHDs). Glycemic control before pregnancy reduces the CHDs. A meta-analysis was used to estimate summary ORs and mathematical modeling population attributable fractions (PAFs) annual number CHDs in U.S. potentially preventable by establishing glycemic pregnancy. Evidence acquisition systematic search literature through December 2012 conducted 2013. Case−control or cohort studies were included. Data abstracted from 12 all synthesis Summary estimates association between PGDM 95% credible intervals (95% CrIs) developed using Bayesian random-effects meta-analyses specific CHD subtypes. Posterior this combined with prevalence produce PAFs prevented cases. Ninety-five percent uncertainty UIs) cases Monte Carlo simulation. Analyses The OR 3.8 CrI=3.0, 4.9). Approximately 2670 UI=1795, 3795) could be annually if women achieved Conclusions Estimates analysis suggest that preconception care have measureable impact reducing infants born