Maternal diabetes and overweight as risk factors for congenital heart defects in offspring - A nationwide register study from Finland
Bibliographic record
Abstract
Abstract Importance Congenital heart defects (CHDs) affect 1–2% of newborns and are associated with significant mortality and morbidity. Understanding risk factors underlying CHDs is essential for prevention. Objective To determine the association between maternal diabetes and overweight/obesity and CHDs among offspring. Design Nationwide population-based register study. Setting Finland Participants All children born between 2006–2016 (N=620 751), and their mothers. Exposures Maternal pre-pregnancy body mass index (BMI) categorized as underweight (<18.5 kg/m 2 ), normal (18.5–24.9 kg/m 2 ), overweight (25.0–29.9 kg/m 2 ), and obese (≥30 kg/m 2 ). Maternal diabetes classified as no diabetes, type 1 (T1DM), type 2/other (T2DM), and gestational diabetes (GDM). Main Outcomes and Measures Odds ratio (OR) of isolated CHD in the child. In addition, nine anatomical CHD subgroups were studied. Results Of the 620 751 children born in Finland during the study period, 10 254 (1.65%) had an isolated CHD. T1DM was associated with an increased risk of having a child with any CHD (OR 3.71 (95% CI 3.16–4.35)), whereas maternal overweight (OR 0.98 (95% CI 0.98–1.04)) and obesity (OR 1.00 (95% CI 0.93–1.07)) were not. When analyzing anatomical subgroups, T1DM was associated with an increased risk in six subgroups. Maternal overweight was associated with complex defects (OR 2.24 (95% CI 1.01–4.94)), left ventricular outflow tract obstruction (OR 1.26, (95% CI 1.07–1.49), maternal obesity with complex defects (OR 3.22 (95% CI 1.31–7.92)), and right ventricular outflow tract obstruction (OR 1.26, (95% CI 1.01–1.55)). At the population level, maternal diabetes was responsible for 3.0% and maternal overweight and obesity for 0.7% of offspring’s CHD. Conclusions and Relevance This study indicated a less profound association between maternal overweight and obesity and CHD in the offspring than previously reported. The different risk profiles of T1DM and overweight/obesity may suggest distinct underlying teratogenic mechanisms.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".