Maternal pre-pregnancy diabetes and risk of all-cause and cause-specific infant mortality
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Maternal pre-pregnancy diabetes is associated with a higher risk of adverse pregnancy outcomes. Few large, cohort studies have assessed associations with a wide large range of causes of infant death. METHODS: This retrospective cohort study included all singleton live births to women aged 18-49 years in the US National Vital Statistics System from 2011 to 2020. Multivariable Poisson regression models were used to estimate adjusted relative risks (RRs) with 95% confidence intervals (CIs) for all-cause and cause-specific infant mortality. RESULTS: Of 34 918 803 pregnant women with singleton live births, 302 823 had pre-pregnancy diabetes with 3585 corresponding infant deaths [estimated mortality rate per 10 000 infants with 95% CI was 78.60 (75.96-81.25)] compared with 34 615 980 without pre-pregnancy diabetes and 171 989 corresponding infant deaths [42.63 (42.41-42.86)]. The adjusted RR (95% CI) of pre-pregnancy diabetes compared with no pre-pregnancy diabetes was 1.84 (1.78-1.91) for infant death, 1.89 (1.81-1.97) for neonatal death, 1.85 (1.77-1.94) for early neonatal death, 2.04 (1.87-2.23) for late neonatal death, and 1.75 (1.65-1.86) for postneonatal deaths. The association was stronger (RR: 2.03, 95% CI: 1.88-2.20) with lower maternal age (<25 years) than with higher maternal age (≥40 years) (RR: 1.44, 95% CI: 1.28-1.63). Associations varied across maternal race, smoking, and body mass index. Significantly increased risk was observed for 48 out of 73 specific causes of death. CONCLUSION: Our findings confirm that maternal pre-pregnancy diabetes is an important risk factor for infant death, encompassing a wide range of causes of death, and suggest that these effects may be systemic given the large number of specific causes of death affected.
DOI: 10.1093/ije/dyaf046
Institutions: Jiangnan University, Norwegian Institute of Public Health, Cancer Registry of Norway, Imperial College London, Universidad Autónoma de Chile, Universidade Federal de São Paulo, Universidad de Santiago de Chile, Wenzhou Medical University, First Affiliated Hospital of Wenzhou Medical University, Fudan University, Zhongshan Hospital, Wuhan University, Sun Yat-sen University, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Northwestern University, Lurie Children's Hospital, University of Oslo, Oslo University Hospital, Glasgow Royal Infirmary, University of Glasgow
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4410520074