Outcomes in Type 1 Diabetic Pregnancies
A nationwide, population-based study
Article Figures & Tables
Tables
- Table 1—
Obstetric complications and fetal characteristics for type 1 diabetic pregnancies and the background population
Type 1 diabetic pregnancy Background population RR (95% CI) or P n 1,215 70,089 Pre-eclampsia* 220 (18.1%) * <0.001 Caesarean section 680 (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 ± 16 280 <0.0001 Birth weight (g) 3,487 ± 817 3,478 0.71 Birth weight ≥4,500 g 97 (8.0%) 2,383 (3.4%) 2.3 (1.9–2.9) Large for gestational age infant‡ 761 (62.5%) — <0.001 Stillbirth 26 (2.1%) 318 (0.45%) 4.7 (3.2–7.0) Perinatal mortality 38 (3.1%) 525 (0.75%) 4.1 (2.9–5.6) Congenital malformations 61 (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 (%).
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↵* Blood pressure ≥140/90 mmHg and proteinuria. The frequency in the background population is 2.6% (other data source, see text);
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↵† before 37 completed weeks of gestation;
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↵‡ birth weight ≥90th centile. The expected frequency in the background population is 10%, but exact numbers are not available;
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↵§ use of continuous positive airway pressure for >1 h postpartum;
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↵‖ 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 outcome Others P n 93 1,125 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 conception 18 (22.5%) 363 (34.6%) 0.019 Preconceptional guidance 38 (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.
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↵* Proliferative retinopathy;
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↵† nephropathy (urine albumin excretion >300 mg/24 h or >200 μg/min);
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↵‡ hypertension (pharmacological treatment) before pregnancy and/or during first trimester;
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↵§ blood pressure ≥140/90 mmHg and proteinuria;
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↵‖ birth weight ≥90th centile.