Educational Objective: There are many causes associated with microtia, both environmental and genetic in origin. Recent literature suggests maternal pregestational and gestational diabetes mellitus are risk factors for congenital microtia. However, the literature regarding this relationship is few and studied in small patient populations. Further research, study, and characterization of this relationship in larger patient cohorts is an invaluable opportunity for prenatal intervention and maternal risk factor mediation. At the conclusion of this presentation, the participants should be able to further characterize the association between maternal diabetes mellitus, sibling history of congenital anomalies, and congenital microtia in a larger cohort study.
Objectives: (1) To further characterize the relationship of maternal diabetes and congenital microtia in a large patient sample; (2) to examine the association of sibling congenital anomaly history and congenital microtia; and (3) to identify opportunities for prenatal intervention and mediation of maternal risk factors.
Study Design: International review board approval was obtained to perform a retrospective chart review of pediatric and adolescent patients (ages 2 months - 18 years) with a diagnosis of microtia in a large patient sample collected at a children's hospital. Descriptive statistics and chi-square analysis are used to assess data and the significance of maternal diabetes, sibling congenital anomaly history, and other maternal risk factors.
Methods: Alongside patient birth history and demographics, maternal health history, age, race/ethnicity, socioeconomic status was collected. Primary outcomes assessed the association of congenital microtia and other congenital otologic defects with a history of maternal diabetes and sibling history of congenital anomalies. A total of 252 pediatric patients with microtia are included in the study.
Results: Current procedural terminology (CPT) codes identified 252 children diagnosed with microtia. Of these patients, 46 (18.25%) were found to have bilateral microtia and 206 (81.75%) with unilateral microtia. 140 individuals were found to have right sided microtia and 65 left sided microtia. Maternal parity was found to be a significant risk factor for unilateral or bilateral microtia in infants (p=.041). Preexisting maternal diabetes is a significant risk factor for microtia (p=.03), however maternal gestational diabetes is not a significant risk factor. Children with microtia were also more likely to have a sibling with a congenital anomaly (p=.02).
Conclusions: Significant risk factors for microtia include maternal parity, preexisting diabetes, and a history of siblings with a congenital anomaly. Our results support the hypothesis that maternal diabetes is a risk factor for microtia, and the larger population size of our study allowed us to demonstrate this significant relationship between maternal diabetes and microtia in children.