Poor Pregnancy Outcome in Women With Type 2 Diabetes
- Tine D. Clausen, MD1,
- Elisabeth Mathiesen, MD, DMSC2,
- Pia Ekbom, MD, PHD2,
- Ellinor Hellmuth, MD1,
- Thomas Mandrup-Poulsen, MD, DMSC34 and
- Peter Damm, MD, DMSC1
- 1Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- 2Department of Medical Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- 3Steno Diabetes Center, Gentofte, Denmark
- 4Department of Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Address correspondence and reprint requests to Tine Dalsgaard Clausen, MD, Department of Obstetrics, 4031, The Juliane Marie Centre Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9 DK-2100, Copenhagen Ø, Denmark. E-mail: tine.clausen{at}rh.dk
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 HbA1c 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.
Footnotes
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T.M.-P. is employed by and holds stock in Novo Nordisk.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many sustances.
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- Accepted October 14, 2004.
- Received June 3, 2004.
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