Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002

  1. F. Dunne*,
  2. P. Brydon,
  3. K. Smith,
  4. H. Gee

Article first published online: 19 AUG 2003

DOI: 10.1046/j.1464-5491.2003.01017.x

Issue

Diabetic Medicine

Diabetic Medicine

Volume 20, Issue 9, pages 734–738, September 2003

Additional Information

How to Cite

Dunne, F., Brydon, P., Smith, K. and Gee, H. (2003), Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002. Diabetic Medicine, 20: 734–738. doi: 10.1046/j.1464-5491.2003.01017.x

Author Information

  1. Departments of Medicine and Obstetrics, Division of Medical Sciences, University of Birmingham and Birmingham Women's Hospital Trust, Birmingham, UK

*Correspondence to: Dr Fidelma Dunne, Department of Medicine, University Hospital Trust, Selly Oak, Raddlebarn Road, Birmingham B29 6JD, UK. E-mail: fidelma.dunne@uhb.nhs.uk

Publication History

  1. Issue published online: 19 AUG 2003
  2. Article first published online: 19 AUG 2003
  3. Accepted 17 March 2003

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Keywords:

  • pregnancy;
  • Type 2 diabetes;
  • maternal morbidity;
  • perinatal mortality;
  • congenital malformations

Abstract

Aim Twelve years’ outcome analysis of pregnancies in women with Type 2 diabetes in a multiethnic geographically defined area.

Methods Information about 182 women delivered between 1990 and 2002 was ascertained from a regional computerized database. The main outcome measures were rates of miscarriage, stillbirth, neonatal/postnatal deaths, congenital malformations, birth weight, mode of delivery, and neonatal unit care as well as maternal morbidities of polyhydramnios, postpartum haemorrhage, pregnancy-induced hypertension/pre-eclampsia.

Results Among 182 singleton pregnancies, 161 (88%) resulted in a live outcome. There were 16 (8.8%) spontaneous miscarriages, two (1.2%) stillbirths, and three (1.6%) terminations. Congenital malformations occurred in 18 pregnancies (99/1000). There were two early and one late neonatal deaths and two further deaths in the postnatal period. Twenty-eight percent of infants were large for gestational age, with 15 (9.3%) greater than 4 kg. Fifty-three percent were delivered by caesarean section and 68 (37%) required admission to neonatal unit (NNU) care. Hypertension/pre-eclampsia was two times, polyhydramnios three times, and postpartum haemorrhage six times more common than in non-diabetic women.

Conclusions Women with Type 2 diabetes have a less satisfactory pregnancy outcome compared with the general population. Infants have a two-fold greater risk of stillbirth, a 2.5-fold greater risk of a perinatal mortality, a 3.5-fold greater risk of death within the first month and a six-fold greater risk of death up to 1 year compared with regional/national figures. They have an 11 times greater risk of a congenital malformation. We need to develop better educational and screening strategies if we are to improve.

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