Open AccessFactors influencing pregnancy outcome in women with type 2 versus type 1 diabetes mellitus
Author(s) -
GONZALEZGONZALEZ NIEVES LUISA,
RAMIREZ OCTAVIO,
MOZAS JUAN,
MELCHOR JUAN,
ARMAS HONORIO,
GARCIAHERNANDEZ JOSE ANGEL,
CABALLERO AGUEDA,
HERNANDEZ MARTA,
DIAZGOMEZ MARTA NIEVES,
JIMENEZ ALEJANDRO,
PARACHE JAVIER,
BARTHA JOSE LUIS
Publication year - 2008
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340701778732
Subject(s) - medicine , pregnancy , obstetrics , caesarean section , birth weight , low birth weight , diabetes mellitus , neonatal intensive care unit , risk factor , pediatrics , endocrinology , genetics , biology
Aim. To compare pregnancy outcome and factors related to adverse perinatal outcome in women with type 1 versus type 2 diabetes mellitus (DM). Material and methods. Multicentre retrospective study. Some 404 women were studied, 257 with type 1 DM and 147 with type 2 DM. Main outcome measures were rates of prematurity, macrosomia, instrumental deliveries, congenital malformations, need for neonatal intensive care unit (NICU), and perinatal mortality. Results. There were no significant differences in pregnancy outcome between women with type 1 and type 2 DM, except for an increased rate of instrumental deliveries in women with type 1 DM. In these women, duration of diabetes was a significant predictor of caesarean delivery (OR =1.06 (1.01–1.12); p = 0.02). Chronic hypertension was positively related to prematurity ( p = 0.02), and proved to be a significant predictor of birth weight lower than 2,500 g (OR =3.54 (1.4–12.49); p = 0.043) and perinatal mortality (OR =10.6 (1.15–117.6); p = 0.04). In women with type 2 DM, third trimester higher glycosylated haemoglobin was related to both prematurity (OR 4.9 (1.7–14.4; p = 0.004) and low birth weight. Macrosomia was a significant risk factor for caesarean section. First trimester glycosylated haemoglobin was related to congenital malformations and proved to be a significant predictor of perinatal mortality (OR =2.4 (1.02–5.74); p = 0.04). Conclusions. Duration of DM and chronic hypertension were the most influential factors related to adverse perinatal outcomes in women with type 1 DM, and poor metabolic control and macrosomia in women with type 2 DM.