CONGENITAL-MALFORMATIONS IN OFFSPRING OF DIABETIC WOMEN TREATED WITH ORAL HYPOGLYCEMIC AGENTS DURING EMBRYOGENESIS

A markedly increased risk (50 %) of congenital malformations in the of fspring of women treated with oral hypoglycaemic agents during the fir st trimester has recently been reported. With this background, the med ical records of a consecutive sample of 25 pregnant Type 2 diabetic wo men treated with oral hypoglycaemic agents during embryogenesis betwee n 1966 and 1991 in the diabetic service of a university hospital, were studied retrospectively. None of the infants had major congenital mal formations disclosed in the neonatal period (0 %, 97.5 % confidence in terval 0.0-13.7 %), but one minor congenital malformation was found (4 .0 %, 95 % confidence interval 0.1-20.3 %). Although this study, due t o the limited number of pregnancies examined, does not exclude an asso ciation between treatment with oral hypoglycaemic agents at the time o f embryogenesis and major congenital malformations in the offspring, t he previously reported association was not confirmed. Thus we find no obvious indication for therapeutic abortions in patients who have acci dentally been treated with oral hypoglycaemic agents during embryogene sis. On the contrary it seems reasonable to reassure these women with respect to their risk of having a malformed baby, stop the treatment w ith oral hypoglycaemic agents and initiate insulin treatment.