Obstetric and perinatal outcomes in type 1 diabetic pregnancies: A large, population-based study
2009 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 32, no 11, 2005-2009 p.Article in journal (Refereed) Published
OBJECTIVE: To perform comparative analyses of obstetric and perinatal outcomes between type 1 diabetic pregnancies and the general obstetric population in Sweden between 1991 and 2003. RESEARCH DESIGN AND METHODS: This was a population-based study. Data were obtained from the Medical Birth Registry, covering >98% of all pregnancies in Sweden. A total of 5,089 type 1 diabetic pregnancies and 1,260,207 control pregnancies were included. Odds ratios (ORs) were adjusted for group differences in maternal age, parity, BMI, chronic hypertensive disease, smoking habits, and ethnicity. RESULTS: In type 1 diabetes, preeclampsia was significantly more frequent (OR 4.47 [3.77-5.31]) as was delivery by cesarean section (5.31 [4.97-5.69]) compared with results for the general population. Stillbirth (3.34 [2.46-4.55]), perinatal mortality (3.29 [2.50-4.33]), and major malformations (2.50 [2.13-2.94]) were more common in type 1 diabetic than in control pregnancies. The risk of very preterm birth (<32 gestational weeks) was also higher among type 1 diabetic women (3.08 [2.45-3.87]). The incidence of fetal macrosomia (birth weight >or=2 SD above the mean) was increased in the diabetic group (11.45 [10.61-12.36]). CONCLUSIONS: Type 1 diabetes in pregnancy is still associated with considerably increased rates of adverse obstetric and perinatal outcomes. The eightfold increased risk for fetal macrosomia in type 1 diabetic pregnancies is unexpected and warrants further investigation.
Place, publisher, year, edition, pages
2009. Vol. 32, no 11, 2005-2009 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-120178DOI: 10.2337/dc09-0656ISI: 000271682800011PubMedID: 19675195OAI: oai:DiVA.org:uu-120178DiVA: diva2:302770