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Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002.
Diabet Med. 2008 Jun; 25(6):708-15.DM

Abstract

AIM

To determine population-based rates and outcomes of pre-gestational diabetes mellitus (pre-GDM) and gestational diabetes mellitus (GDM) in pregnancy.

METHODS

This was a cross-sectional study, using linked population databases, of all women, and their infants, discharged from hospital following birth in New South Wales (NSW) between 1 July 1998 and 31 December 2002. Women with, and infants exposed to pre-GDM or GDM were compared with those without diabetes mellitus for pregnancy characteristics and outcomes.

RESULTS

Women with a singleton pregnancy (n = 370,703) and their infants were included: 1248 women (0.3%) had pre-GDM and 17,128 (4.5%) had GDM. Of those women with pre-GDM, 57% had Type 1 diabetes, 20% had Type 2 diabetes and for 23% the type of diabetes was unknown. Major maternal morbidity or mortality was more common in women with pre-GDM (7.9%) [odds ratio (OR) 3.2, 95% confidence interval (CI) 2.6, 3.9] and in women with GDM (3.1%) (OR 1.2, 95% CI 1.1, 1.4) when compared with women without diabetes (2.6%). Major infant morbidity or mortality occurred more frequently in infants exposed to pre-GDM compared with no diabetes (13.6% vs. 3.1%) (OR 5.0, 95% CI 4.2, 5.8) and in infants exposed to GDM compared with no diabetes (3.2% vs. 2.3%) (OR 1.4, 95% CI 1.3, 1.5).

CONCLUSIONS

Pre-GDM and GDM continue to be associated with an increased risk of adverse maternal and neonatal outcomes; however, women with GDM have adverse outcomes less frequently. Rates of GDM and pre-GDM appear to be increasing over time. Clinicians should consider the potential for adverse outcomes, and arrange referral to appropriate services.

Authors+Show Affiliations

School of Women's and Infants' Health, The University of Western Australia, Perth, Australia. awshand@yahoo.com.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18544109

Citation

Shand, A W., et al. "Outcomes of Pregnancies in Women With Pre-gestational Diabetes Mellitus and Gestational Diabetes Mellitus; a Population-based Study in New South Wales, Australia, 1998-2002." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 25, no. 6, 2008, pp. 708-15.
Shand AW, Bell JC, McElduff A, et al. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002. Diabet Med. 2008;25(6):708-15.
Shand, A. W., Bell, J. C., McElduff, A., Morris, J., & Roberts, C. L. (2008). Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002. Diabetic Medicine : a Journal of the British Diabetic Association, 25(6), 708-15. https://doi.org/10.1111/j.1464-5491.2008.02431.x
Shand AW, et al. Outcomes of Pregnancies in Women With Pre-gestational Diabetes Mellitus and Gestational Diabetes Mellitus; a Population-based Study in New South Wales, Australia, 1998-2002. Diabet Med. 2008;25(6):708-15. PubMed PMID: 18544109.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002. AU - Shand,A W, AU - Bell,J C, AU - McElduff,A, AU - Morris,J, AU - Roberts,C L, PY - 2008/6/12/pubmed PY - 2008/8/2/medline PY - 2008/6/12/entrez SP - 708 EP - 15 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 25 IS - 6 N2 - AIM: To determine population-based rates and outcomes of pre-gestational diabetes mellitus (pre-GDM) and gestational diabetes mellitus (GDM) in pregnancy. METHODS: This was a cross-sectional study, using linked population databases, of all women, and their infants, discharged from hospital following birth in New South Wales (NSW) between 1 July 1998 and 31 December 2002. Women with, and infants exposed to pre-GDM or GDM were compared with those without diabetes mellitus for pregnancy characteristics and outcomes. RESULTS: Women with a singleton pregnancy (n = 370,703) and their infants were included: 1248 women (0.3%) had pre-GDM and 17,128 (4.5%) had GDM. Of those women with pre-GDM, 57% had Type 1 diabetes, 20% had Type 2 diabetes and for 23% the type of diabetes was unknown. Major maternal morbidity or mortality was more common in women with pre-GDM (7.9%) [odds ratio (OR) 3.2, 95% confidence interval (CI) 2.6, 3.9] and in women with GDM (3.1%) (OR 1.2, 95% CI 1.1, 1.4) when compared with women without diabetes (2.6%). Major infant morbidity or mortality occurred more frequently in infants exposed to pre-GDM compared with no diabetes (13.6% vs. 3.1%) (OR 5.0, 95% CI 4.2, 5.8) and in infants exposed to GDM compared with no diabetes (3.2% vs. 2.3%) (OR 1.4, 95% CI 1.3, 1.5). CONCLUSIONS: Pre-GDM and GDM continue to be associated with an increased risk of adverse maternal and neonatal outcomes; however, women with GDM have adverse outcomes less frequently. Rates of GDM and pre-GDM appear to be increasing over time. Clinicians should consider the potential for adverse outcomes, and arrange referral to appropriate services. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/18544109/Outcomes_of_pregnancies_in_women_with_pre_gestational_diabetes_mellitus_and_gestational_diabetes_mellitus L2 - https://doi.org/10.1111/j.1464-5491.2008.02431.x DB - PRIME DP - Unbound Medicine ER -