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Perinatal mortality in Japanese women diagnosed with gestational diabetes mellitus and diabetes mellitus
Author(s) -
Morikawa Mamoru,
Sugiyama Takashi,
Sagawa Norimasa,
Hiramatsu Yuji,
Ishikawa Hiroshi,
Hamada Hiromi,
Kameda Takashi,
Hara Emiko,
Toda Shigeru,
Minakami Hisanori
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13431
Subject(s) - medicine , gestational diabetes , obstetrics , diabetes mellitus , population , pregnancy , pediatrics , gestation , endocrinology , genetics , environmental health , biology
Aims The objective of this study was to determine how many pregnant Japanese women with diabetes mellitus (DM)/gestational diabetes mellitus (GDM) experience perinatal mortality in the presence of fetal anomalies. Methods Our investigation included data from 205 secondary/tertiary obstetric facilities located widely in Japan. The Japan Ministry of Health, Labour and Welfare Vital Statistics of Japan was used for comparison. Results Of 237 941 women giving birth at 205 hospitals, 1796 (0.8%) and 13 037 (5.5%) had DM and GDM, respectively. The perinatal mortality rates (per 1000 births) were 10.6 (19/1796) for women with DM, 5.2 (68/13037) for women with GDM, and 3.7 (7612/2039504) for the general Japanese population. Detailed information was available for 63 (72%) of the 87 perinatal deaths occurring in women with diabetes including DM and GDM; fetal anomalies were associated with 40% (25/63) of perinatal deaths, exceeding 16% (1211/7612) in the general Japanese population ( P < 0.0001). The leading four fetal anomalies associated with perinatal mortality in women with diabetes were fetal trisomy (6 cases: 1 of trisomy‐13 and 5 of trisomy‐18), non‐immune hydrops fetalis (5 cases), cardiac deformities (3 cases) and holoprosencephaly (2 cases). Conclusions Perinatal mortality was more likely to occur in women with glucose intolerance. In the Japanese infants that succumbed to perinatal mortality, fetal anomaly was more prevalent in those born to women with a glucose intolerance than in those born to the general population.