Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002
- 19 August 2003
- journal article
- research article
- Published by Wiley in Diabetic Medicine
- Vol. 20 (9) , 734-738
- https://doi.org/10.1046/j.1464-5491.2003.01017.x
Abstract
Aim Twelve years’ outcome analysis of pregnancies in women with Type 2 diabetes in a multiethnic geographically defined area.Methods Information about 182 women delivered between 1990 and 2002 was ascertained from a regional computerized database. The main outcome measures were rates of miscarriage, stillbirth, neonatal/postnatal deaths, congenital malformations, birth weight, mode of delivery, and neonatal unit care as well as maternal morbidities of polyhydramnios, postpartum haemorrhage, pregnancy‐induced hypertension/pre‐eclampsia.Results Among 182 singleton pregnancies, 161 (88%) resulted in a live outcome. There were 16 (8.8%) spontaneous miscarriages, two (1.2%) stillbirths, and three (1.6%) terminations. Congenital malformations occurred in 18 pregnancies (99/1000). There were two early and one late neonatal deaths and two further deaths in the postnatal period. Twenty‐eight percent of infants were large for gestational age, with 15 (9.3%) greater than 4 kg. Fifty‐three percent were delivered by caesarean section and 68 (37%) required admission to neonatal unit (NNU) care. Hypertension/pre‐eclampsia was two times, polyhydramnios three times, and postpartum haemorrhage six times more common than in non‐diabetic women.Conclusions Women with Type 2 diabetes have a less satisfactory pregnancy outcome compared with the general population. Infants have a two‐fold greater risk of stillbirth, a 2.5‐fold greater risk of a perinatal mortality, a 3.5‐fold greater risk of death within the first month and a six‐fold greater risk of death up to 1 year compared with regional/national figures. They have an 11 times greater risk of a congenital malformation. We need to develop better educational and screening strategies if we are to improve.Keywords
This publication has 27 references indexed in Scilit:
- Type 2 diabetes in adolescence - unearthed at the time of registration with the general practitioner (GP)Practical Diabetes International, 2000
- Commonwealth Association of Paediatric Gastroenterology; 12th Commonwealth Health Ministers MeetingJournal of Pediatric Gastroenterology and Nutrition, 1999
- PREGNANCY IN DIABETESMedical Clinics of North America, 1998
- Prospective population based survey of outcome of pregnancy in diabetic women: results of the Northern Diabetic Pregnancy Audit, 1994BMJ, 1997
- Short- and long-range complications in offspring of diabetic mothersJournal of Diabetes and its Complications, 1996
- Pregnancy outcomes in the Diabetes Control and Complications TrialAmerican Journal of Obstetrics and Gynecology, 1996
- Congenital Malformations in Pregnancies Complicated by NIDDM: Increased risk from poor maternal metabolic control but not from exposure to sulfonylurea drugsDiabetes Care, 1995
- Can prepregnancy care of diabetic women reduce the risk of abnormal babies?BMJ, 1990
- Perinatal Mortality and Congenital Malformations in Infants Born to Women With Insulin-Dependent Diabetes Mellitus—United States, Canada, and Europe, 1940-1988Published by American Medical Association (AMA) ,1990
- Incidence of Spontaneous Abortion among Normal Women and Insulin-Dependent Diabetic Women Whose Pregnancies Were Identified within 21 Days of ConceptionNew England Journal of Medicine, 1988