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We collected data from the electronic hospital records. Congenital anomalies were classified by the 10\n                      <jats:sup>th<\/jats:sup>\n                      revised International Classification of Diseases, Q chapter, enhanced by the EUROCAT registry classification, and categorized by type and gravity. We used multiple Poisson regression with robust estimates to estimate risks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 648 participants, we excluded 19, and 62 were lost to follow-up; therefore, we included 567 participants. Overt diabetes arose in 191 participants (33.7%, 95% CI 30.0% \u2013 38.0%). Less than 20% of the participants supplemented folate. Congenital anomalies occurred in 78 neonates (13.8%, CI 11.0 \u2212\u200916.9%), 73 babies (93.6%) presented major anomalies, and 20 (10.5%) cases occurred in participants with overt diabetes. Cardiac anomalies were the most frequent (43 isolated and 12 combined). Pre-eclampsia was associated with an increased risk in the analyses including all women (adjusted RR 1.87 (95% CI 1.23\u20132.85),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), but not in analyses including only women with an HbA1c measured up to the 14\n                      <jats:sup>th<\/jats:sup>\n                      gestational age. HbA1c, either measured at any time in pregnancy (adjusted RR 1.21 (95% CI 1.10\u20131.33),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) or up to the first 14 weeks (adjusted RR 1.22, 95% CI 1.10\u20131.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) was the only sustained risk factor. Risk factors such as maternal age, obesity, diabetes diagnosis, or use of antidiabetic medications were not associated with congenital anomalies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found a high frequency of congenital anomalies associated with poor maternal glycemic control and revealed an almost universal lack of preconception care. An urgent call to action is mandatory for the reversal of this gray scenario.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13098-024-01376-y","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T03:02:05Z","timestamp":1720666925000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Congenital anomalies in pregnancies with overt and pregestational type 2 diabetes: a gray portrayal from a cohort in Brazil"],"prefix":"10.1186","volume":"16","author":[{"given":"Maria Am\u00e9lia A","family":"Campos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria L\u00facia R","family":"Oppermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa V","family":"Sanseverino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia L","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e2nia N","family":"Hirakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela J","family":"Reichelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"key":"1376_CR1","unstructured":"International Diabetes Federation. 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Information was collected from the electronic medical registries of each hospital. All authors signed a data use agreement form to ensure the privacy of the data collected from medical registries. The ethics committees of both hospitals approved the study protocol on July 28, 2016 (number 16\u20130331) and the study is registered at <i>Plataforma Brasil<\/i>, CAAE 57365016.3.0000.5327.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"157"}}