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Obstetric and perinatal outcomes in type 1 diabetic pregnancies: A large, population-based study
Dept of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Obstetrisk forskning/Axelsson)
2009 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 32, no 11, 2005-2009 p.Article in journal (Refereed) Published
Abstract [en]

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.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-120178DOI: 10.2337/dc09-0656ISI: 000271682800011PubMedID: 19675195OAI: oai:DiVA.org:uu-120178DiVA: diva2:302770
Available from: 2010-03-09 Created: 2010-03-09 Last updated: 2010-06-29Bibliographically approved

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