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Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden.
BMC Pregnancy Childbirth. 2019 May 07; 19(1):159.BP

Abstract

BACKGROUND

Diabetes during pregnancy is an increasingly common metabolic disorder, associated with significantly increased risks for both mother and child. Aim of this study was to compare maternal and perinatal outcomes in women with pregestational (PDM) type 1 (T1DM), type 2 diabetes (T2DM), gestational diabetes mellitus (GDM) and compare these to pregnancies not complicated with diabetes. This study also evaluated a specifically organized care-model mostly involving specialist diabetes nurses.

METHODS

Retrospective population-based records review 2009-2012. Rates of maternal (preeclampsia, pre-term delivery, cesarean section (CS)) and fetal outcomes (large for gestational age (LGA), macrosomia, congenital malformations/intrauterine death) were assessed and potential predisposing or contributing factors as maternal age, ethnicity, obesity, weight gain, parity, HbA1c levels, insulin types and doses.

RESULTS

Among 280 pregnancies 48 were PDM, 97 GDM and 135 without diabetes. Within the group with diabetes, early-pregnancy BMI was higher (p = 0.0001), pregnancy weight gain lower (11.1 ± 6.7 kg vs 13.1 ± 7.1 kg, p = 0.005), more delivered preterm (p = 0.0001), by CS (p = 0.05), and had more LGA neonates (p = 0.06) than the group without diabetes. Among pregnancies with diabetes, GDM mothers gained less weight (9.9 kg vs 13.5 kg) (p = 0.006), and rates of CS (p = 0.03), preterm deliveries (p = 0.001) and LGA (p = 0.0001) were not increased compared to PDM; More T1DM infants were LGA, 60% vs. 27% in T2DM. In pregnancies with diabetes obesity, excessive weight gain and multiparity were associated with increased risk of LGA neonates, and mother's type of diabetes and gestational week were associated with higher rates of CS.

CONCLUSION

Weight gain during pregnancy was lower in pregnancies with diabetes and prevalence of LGA, CS and preterm deliveries in GDM was not elevated, also for T2DM, except increased prevalence of LGA in T1DM that warrants increased clinical attention, indicating that this model of antenatal diabetes care may have contributed to improved maternal and fetal outcomes.

Authors+Show Affiliations

Department of Clinical Sciences, Endocrinology and Diabetes, Lund University, Lund, Sweden. anna.stogianni@kronoberg.se. Department of Internal Medicine, Endocrinology and Diabetes, Central Hospital, Region Kronoberg, S-351 85, Växjö, Sweden. anna.stogianni@kronoberg.se. Department of Endocrinology, Skåne University Hospital, Lund, Sweden. anna.stogianni@kronoberg.se.Department of Research and Development, Region Kronoberg, Växjö, Kronoberg, Sweden. Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.Department of Clinical Sciences, Endocrinology and Diabetes, Lund University, Lund, Sweden. Department of Endocrinology, Skåne University Hospital, Lund, Sweden.Department of Clinical Sciences, Endocrinology and Diabetes, Lund University, Lund, Sweden. Department of Internal Medicine, Endocrinology and Diabetes, Central Hospital, Region Kronoberg, S-351 85, Växjö, Sweden. Department of Research and Development, Region Kronoberg, Växjö, Kronoberg, Sweden.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

31064335

Citation

Stogianni, Anna, et al. "Obstetric and Perinatal Outcomes in Pregnancies Complicated By Diabetes, and Control Pregnancies, in Kronoberg, Sweden." BMC Pregnancy and Childbirth, vol. 19, no. 1, 2019, p. 159.
Stogianni A, Lendahls L, Landin-Olsson M, et al. Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden. BMC Pregnancy Childbirth. 2019;19(1):159.
Stogianni, A., Lendahls, L., Landin-Olsson, M., & Thunander, M. (2019). Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden. BMC Pregnancy and Childbirth, 19(1), 159. https://doi.org/10.1186/s12884-019-2269-8
Stogianni A, et al. Obstetric and Perinatal Outcomes in Pregnancies Complicated By Diabetes, and Control Pregnancies, in Kronoberg, Sweden. BMC Pregnancy Childbirth. 2019 May 7;19(1):159. PubMed PMID: 31064335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden. AU - Stogianni,Anna, AU - Lendahls,Lena, AU - Landin-Olsson,Mona, AU - Thunander,Maria, Y1 - 2019/05/07/ PY - 2018/10/12/received PY - 2019/03/27/accepted PY - 2019/5/9/entrez PY - 2019/5/9/pubmed PY - 2019/5/9/medline KW - Cesarean section KW - Gestational diabetes KW - HbA1c KW - Insulin KW - Pregestational diabetes KW - Type 1 diabetes KW - Type 2 diabetes SP - 159 EP - 159 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 19 IS - 1 N2 - BACKGROUND: Diabetes during pregnancy is an increasingly common metabolic disorder, associated with significantly increased risks for both mother and child. Aim of this study was to compare maternal and perinatal outcomes in women with pregestational (PDM) type 1 (T1DM), type 2 diabetes (T2DM), gestational diabetes mellitus (GDM) and compare these to pregnancies not complicated with diabetes. This study also evaluated a specifically organized care-model mostly involving specialist diabetes nurses. METHODS: Retrospective population-based records review 2009-2012. Rates of maternal (preeclampsia, pre-term delivery, cesarean section (CS)) and fetal outcomes (large for gestational age (LGA), macrosomia, congenital malformations/intrauterine death) were assessed and potential predisposing or contributing factors as maternal age, ethnicity, obesity, weight gain, parity, HbA1c levels, insulin types and doses. RESULTS: Among 280 pregnancies 48 were PDM, 97 GDM and 135 without diabetes. Within the group with diabetes, early-pregnancy BMI was higher (p = 0.0001), pregnancy weight gain lower (11.1 ± 6.7 kg vs 13.1 ± 7.1 kg, p = 0.005), more delivered preterm (p = 0.0001), by CS (p = 0.05), and had more LGA neonates (p = 0.06) than the group without diabetes. Among pregnancies with diabetes, GDM mothers gained less weight (9.9 kg vs 13.5 kg) (p = 0.006), and rates of CS (p = 0.03), preterm deliveries (p = 0.001) and LGA (p = 0.0001) were not increased compared to PDM; More T1DM infants were LGA, 60% vs. 27% in T2DM. In pregnancies with diabetes obesity, excessive weight gain and multiparity were associated with increased risk of LGA neonates, and mother's type of diabetes and gestational week were associated with higher rates of CS. CONCLUSION: Weight gain during pregnancy was lower in pregnancies with diabetes and prevalence of LGA, CS and preterm deliveries in GDM was not elevated, also for T2DM, except increased prevalence of LGA in T1DM that warrants increased clinical attention, indicating that this model of antenatal diabetes care may have contributed to improved maternal and fetal outcomes. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/31064335/Obstetric_and_perinatal_outcomes_in_pregnancies_complicated_by_diabetes_and_control_pregnancies_in_Kronoberg_Sweden_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2269-8 DB - PRIME DP - Unbound Medicine ER -