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Poor Pregnancy Outcome in Women With Type 2 Diabetes

Author:
Clausen, Tine D., Mathiesen, Elisabeth, Ekbom, Pia, Hellmuth, Ellinor, Mandrup-Poulsen, Thomas, Damm, Peter
Source:
Diabetes care 2005 v.28 no.2 pp. 323-328
ISSN:
0149-5992
Subject:
congenital abnormalities, glycemic control, insulin-dependent diabetes mellitus, mortality, noninsulin-dependent diabetes mellitus, pregnancy outcome, pregnant women, regression analysis
Abstract:
OBJECTIVE:-- To evaluate the perinatal outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996-2001. RESEARCH DESIGN AND METHODS-- Medical records of 61 consecutive singleton pregnancies in women with type 2 diabetes from 1996 to 2001 were studied. Pregnancy outcome was compared with that of pregnant women with type 1 diabetes during 1996-2000, the background population, and pregnant women with type 2 diabetes during 1980-1992 from the same department. RESULTS:-- The perinatal mortality in pregnancies complicated by type 2 diabetes (4/61, 6.6%) was increased four- and ninefold, respectively, and the rate of major congenital malformations (4/60, 6.7%) was more than doubled, although not statistically significant, compared with type 1 diabetic pregnancies and the background population. The glycemic control was similar or better in women with type 2 diabetes compared with women with type 1 diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational diabetes from 1996 to 2001 showed that high HbA[subscript 1c] at admission and type 2 diabetes were independently associated with a serious adverse fetal outcome (perinatal mortality and/or major congenital malformations). The perinatal mortality and the rate of major congenital malformations in type 2 diabetic pregnancies have increased during the last decade. CONCLUSIONS:-- The perinatal outcome of pregnancies in women with type 2 diabetes during 1996-2001 is poor. It is worse than the outcome of pregnancies in women with type 1 diabetes and the background population in the same period, as well as in women with type 2 diabetes studied during 1982-1990.
Agid:
252488