-
BJOG.
2003 Mar;110(3):315-8.
-
Outcomes
of
pregnancies
in
women
with
type
1
diabetes
in
Scotland:
a
national
population-based
study.
University
of
Edinburgh,
UK.
Objectives:
To
determine
the
outcomes
of
pregnancies
in
women
with
pre-existing,
type
1
diabetes.
Design:
Prospective,
population-based
cohort.
Setting:
Scotland.
POPULATION:
All
273
women
with
type
1
diabetes
with
a
pregnancy
ending
(in
miscarriage,
abortion
or
delivery)
during
the
12
months
(from
April
1,
1998
to
March
31,
1999).
Methods:
Pregnancies
identified
prospectively
by
clinicians
in
each
hospital;
outcome
data
collected
from
case
records
and
from
Scottish
national
data
sets.
MAIN
OUTCOME
MEASURES:
Perinatal
and
infant
mortality,
congenital
anomaly
and
birthweight.
Results:
Of
the
273
pregnancies,
40
(14.7%)
ended
in
miscarriage,
20
(7.3%)
in
abortion
and
213
(78%)
in
delivery.
Three
deliveries
were
twin
births,
thus
216
babies
were
born.
Stillbirth
rate
(4/216):
18.5
(95%
CI
5.1-46.8)
per
1000
total
births;
perinatal
mortality
rate
(6/216):
27.8
(95%
CI
10.2-59.4)
per
1000
births.
There
were
13
verified
congenital
anomalies
(in
six
abortions
and
seven
live
births),
anomaly
rate:
60
(95%
CI
32-101)
per
1000
total
births.
Among
208
singleton,
live
born
infants,
the
mean
birthweight
was
3427
g.
Standardised
birthweight
scores,
relative
to a
reference
population,
showed
a
unimodal
distribution,
shifted
to
the
right
(mean,
1.57
SD).
Conclusions:
In
an
unselected
population,
adverse
outcomes
remain
more
common
among
the
infants
of
mothers
with
type
1
diabetes
than
in
the
general
population.
The
targets
of
the
St
Vincent
Declaration
of
1989
have
not
been
met.
Improvements
may
be
gained
by
increases
in
provision
of
prepregnancy
care
and
in
the
proportion
of
pregnancies
that
are
planned.
However,
further
research
is
needed
to
clarify
the
root
causes
of
adverse
outcomes
in
the
pregnancies
of
women
with
diabetes.
