Diabetes in Pregnancy

BMJ. 1997 Aug 2;315(7103):279-81.

Prospective population based survey of outcome of pregnancy in diabetic women: results of the Northern Diabetic Pregnancy Audit, 1994.
Hawthorne G, Robson S, Ryall EA, Sen D, Roberts SH, Ward Platt MP.

Objectives:

To determine whether the St Vincent declaration (1989) target of diabetic pregnancy outcome approximating non-diabetic pregnancy outcome in near to being achieved.

Design:

Prospective collection of population based information on pregnancies in women with diabetes from all participating hospitals.

Setting:

District general and teaching hospitals of the former Northern region. SUBJECTS: 111 diabetic women booking with pregnancy during 1 January to 31 December 1994. MAIN OUTCOME MEASURES: Diabetic control, perinatal mortality rate, fetal abnormality rate.

Results:

The perinatal mortality rate was 48/1000 for diabetic pregnancies compared with 8.9/1000 for the background population (odds ratio 5.38; 95% confidence interval 2.27 to 12.70) and the neonatal mortality rate was 59/1000 compared with 3.9/1000 (15.0; 6.77 to 33.10). Two late neonatal deaths were due to congenital heart defects. Six per cent of all fetal losses (6/109 cases) were due to major malformations. The congenital malformation rate was 83/1000 compared with 21.3/1000 (3.76; 2.00 to 7.06) in the background population.

Conclusions:

Diabetic pregnancy remains a high risk state with perinatal mortality and fetal malformation rates much higher than in the background population.