Audit on Stillbirths in Women With Pregestational Type 1 Diabetes

  1. Jeannet Lauenborg, MD1,
  2. Elisabeth Mathiesen, MD, PHD2,
  3. Per Ovesen, MD, PHD3,
  4. Jes G. Westergaard, MD, PHD4,
  5. Pia Ekbom, MD2,
  6. Lars Mølsted-Pedersen, MD, PHD5 and
  7. Peter Damm, MD, PHD1
  1. 1Obstetric Clinic, the Juliane Marie Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark
  2. 2Department of Endocrinology, National University Hospital, Rigshospitalet, Copenhagen, Denmark
  3. 3Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Denmark
  4. 4Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
  5. 5Department of Obstetrics and Gynecology, Copenhagen University Hospital, Glostrup, Denmark

    Abstract

    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.

    Footnotes

    • Address correspondence and reprint requests to Jeannet Lauenborg, Obstetric Clinic, the Juliane Marie Center, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ö, Denmark. E-mail: lauenborg{at}dadlnet.dk.

      Received for publication 8 November 2002 and accepted in revised form 25 January 2003.

      A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

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