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Audit on Stillbirths in Women With Pregestational Type 1 Diabetes

¹ Obstetric Clinic, the Juliane Marie Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark
² Department of Endocrinology, National University Hospital, Rigshospitalet, Copenhagen, Denmark
³ Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Denmark
⁴ Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
⁵ Department of Obstetrics and Gynecology, Copenhagen University Hospital, Glostrup, Denmark

OBJECTIVE—To audit stillbirth cases in women with type 1 diabetes to search for specific characteristics in order to improve antenatal care and treatment

RESEARCH DESIGN AND METHODS—Retrospectively identified cases of stillbirths in women with type 1 diabetes during 1990–2000 were analyzed regarding characteristics of the mother, the pregnancy, glycemic control, and the stillborn. The cause of stillbirth was categorized as explainable, likely, or without obvious cause.

RESULTS—We found 22 women with 25 stillbirths among 1,361 singleton births by women with type 1 diabetes. In seven stillbirths the cause was categorized as explainable and in six as likely. In 12 cases no obvious cause was found; however, glycemic control was suboptimal in 9 of these cases. A total of 14 women reported daily smoking, and 10 of 19 with low education were unemployed.

CONCLUSIONS—Women experiencing stillbirth were characterized by a high incidence of suboptimal glycemic control, diabetic nephropathy, smoking, and low social status.

Abbreviations: AGA, appropriate for gestational age • GA, gestational age • LGA, large for gestational age • SGA, small for gestational age

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