Poor Pregnancy Outcome in Women With Type 2 Diabetes

Poor Pregnancy Outcome in Women With Type 2 Diabetes
2005
Tine D. Clausen, MD1, Elisabeth Mathiesen, MD, DMSC2, Pia Ekbom, MD, PHD2, Ellinor Hellmuth, MD1, Thomas Mandrup-Poulsen, MD, DMSC3,4 and Peter Damm, MD, DMSC1
Diabetes Care

© 2005 by the American Diabetes Association, Inc.

1 Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
2 Department of Medical Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
3 Steno Diabetes Center, Gentofte, Denmark
4 Department of Molecular Medicine, Karolinska Institute, Stockholm, Sweden

Address correspondence and reprint requests to Tine Dalsgaard Clausen, MD, Department of Obstetrics, 4031, The Juliane Marie Centre Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9 DK-2100, Copenhagen ?, Denmark. E-mail: tine.clausen@rh.dk

ABSTRACT

OBJECTIVEÛ To evaluate the perinatal outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996Ò2001.

RESEARCH DESIGN AND METHODSÛ Medical records of 61 consecutive singleton pregnancies in women with type 2 diabetes from 1996 to 2001 were studied. Pregnancy outcome was compared with that of pregnant women with type 1 diabetes during 1996Ò2000, the background population, and pregnant women with type 2 diabetes during 1980Ò1992 from the same department.

RESULTSÛ The perinatal mortality in pregnancies complicated by type 2 diabetes (4/61, 6.6%) was increased four- and ninefold, respectively, and the rate of major congenital malformations (4/60, 6.7%) was more than doubled, although not statistically significant, compared with type 1 diabetic pregnancies and the background population. The glycemic control was similar or better in women with type 2 diabetes compared with women with type 1 diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational diabetes from 1996 to 2001 showed that high HbA1c at admission and type 2 diabetes were independently associated with a serious adverse fetal outcome (perinatal mortality and/or major congenital malformations). The perinatal mortality and the rate of major congenital malformations in type 2 diabetic pregnancies have increased during the last decade.

CONCLUSIONSÛ The perinatal outcome of pregnancies in women with type 2 diabetes during 1996Ò2001 is poor. It is worse than the outcome of pregnancies in women with type 1 diabetes and the background population in the same period, as well as in women with type 2 diabetes studied during 1982Ò1990.

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