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Epidemiology/Health Services/Psychosocial Research

Outcomes in Type 1 Diabetic Pregnancies

A nationwide, population-based study

  1. Dorte M. Jensen, PHD1,
  2. Peter Damm, DMSC2,
  3. Lars Moelsted-Pedersen, DMSC3,
  4. Per Ovesen, DMSC4,
  5. Jes G. Westergaard, DMSC5,
  6. Margrethe Moeller, MD6 and
  7. Henning Beck-Nielsen, DMSC1
  1. 1Department of Endocrinology, Odense University Hospital, Odense, Denmark
  2. 2Obstetric Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  3. 3Department of Obstetrics and Gynaecology, Copenhagen County Hospital, Glostrup, University of Copenhagen, Copenhagen, Denmark
  4. 4Department of Obstetrics and Gynaecology, Aarhus University Hospital, Skejby Sygehus, Aarhus, Denmark
  5. 5Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
  6. 6Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
  1. Address correspondence and reprint requests to Henning Beck-Nielsen and Dorte M. Jensen, Department of Endocrinology, Odense University Hospital, Kløvervænget 6 DK-5000, Odense, Denmark. E-mail: dortemj{at}dadlnet.dk
Diabetes Care 2004 Dec; 27(12): 2819-2823. https://doi.org/10.2337/diacare.27.12.2819
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Article Figures & Tables

Tables

  • Table 1—

    Obstetric complications and fetal characteristics for type 1 diabetic pregnancies and the background population

    Type 1 diabetic pregnancyBackground populationRR (95% CI) or P
    n1,21570,089
    Pre-eclampsia*220 (18.1%)*<0.001
    Caesarean section680 (55.9%)8,831 (12.6%)4.4 (4.1–4.8)
    Preterm delivery†507 (41.7%)4,205 (6.0%)7.0 (6.3–7.6)
    Gestational age at delivery (days)256 ± 16280<0.0001
    Birth weight (g)3,487 ± 8173,4780.71
    Birth weight ≥4,500 g97 (8.0%)2,383 (3.4%)2.3 (1.9–2.9)
    Large for gestational age infant‡761 (62.5%)—<0.001
    Stillbirth26 (2.1%)318 (0.45%)4.7 (3.2–7.0)
    Perinatal mortality38 (3.1%)525 (0.75%)4.1 (2.9–5.6)
    Congenital malformations61 (5.0%)1,987 (2.8%)1.7 (1.3–2.2)
    Respiratory distress syndrome§202 (17.1%)ND—
    Jaundice‖215 (18.1%)ND—
    • Data are means ± SD or n (%).

    • *

      ↵* Blood pressure ≥140/90 mmHg and proteinuria. The frequency in the background population is 2.6% (other data source, see text);

    • †

      ↵† before 37 completed weeks of gestation;

    • ‡

      ↵‡ birth weight ≥90th centile. The expected frequency in the background population is 10%, but exact numbers are not available;

    • §

      ↵§ use of continuous positive airway pressure for >1 h postpartum;

    • ‖

      ↵‖ use of phototherapy. ND, no data.

  • Table 2—

    Maternal characteristics in pregnancies with serious adverse outcomes (perinatal death and/or congenital malformations) versus other pregnancies

    Serious adverse outcomeOthersP
    n931,125
    Age (years)28 (25–31)29 (26–32)0.49
    Preconceptional BMI (kg/m2)22.1 (19.4–24.2)23.0 (21.4–25.3)0.01
    Diabetes duration (years)12 (6–18)12 (5–19)0.75
    Daily blood glucose monitoring at conception18 (22.5%)363 (34.6%)0.019
    Preconceptional guidance38 (42.7%)631 (59.2%)0.002
    HbA1c 0–3 months prior to conception (%)8.0 (7.3–9.1)7.6 (6.8–8.5)0.005
    HbA1c during first trimester (%)7.6 (6.6–8.6)7.3 (6.6–8.1)0.037
    HbA1c during second trimester (%)6.9 (6.2–8.0)6.6 (6.0–7.3)0.012
    HbA1c during third trimester (%)7.1 (6.5–7.9)6.7 (6.2–7.4)<0.001
    Retinopathy*5 (5.8%)78 (7.3%)0.58
    Nephropathy†8 (9.0%)70 (6.4%)0.34
    Hypertension‡6 (6.7%)53 (4.8%)0.45
    Pre-eclampsia§15 (18.1%)205 (18.1%)1.0
    Large for gestational age infant‖48 (57.1%)713 (62.9%)0.30
    • Data are median (interquartile range) or n (%). For some of the variables, the total number is <1,218 due to missing values.

    • *

      ↵* Proliferative retinopathy;

    • †

      ↵† nephropathy (urine albumin excretion >300 mg/24 h or >200 μg/min);

    • ‡

      ↵‡ hypertension (pharmacological treatment) before pregnancy and/or during first trimester;

    • §

      ↵§ blood pressure ≥140/90 mmHg and proteinuria;

    • ‖

      ↵‖ birth weight ≥90th centile.

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Diabetes Care: 27 (12)

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December 2004, 27(12)
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Outcomes in Type 1 Diabetic Pregnancies
Dorte M. Jensen, Peter Damm, Lars Moelsted-Pedersen, Per Ovesen, Jes G. Westergaard, Margrethe Moeller, Henning Beck-Nielsen
Diabetes Care Dec 2004, 27 (12) 2819-2823; DOI: 10.2337/diacare.27.12.2819

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Outcomes in Type 1 Diabetic Pregnancies
Dorte M. Jensen, Peter Damm, Lars Moelsted-Pedersen, Per Ovesen, Jes G. Westergaard, Margrethe Moeller, Henning Beck-Nielsen
Diabetes Care Dec 2004, 27 (12) 2819-2823; DOI: 10.2337/diacare.27.12.2819
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