Metabolic control and pregnancy outcome among women with insulin-dependent diabetes mellitus. A twelve-year follow-up in the country of Jämtland, Sweden

Acta Obstetricia Et Gynecologica Scandinavica
L NordströmO Wålinder

Abstract

To assess metabolic control and pregnancy outcome in women with insulin-dependent diabetes mellitus (IDDM) in a defined rural area of Sweden and to compare results for three four-year periods (1982-85, 1986-89, 1990-93). All pregnancies in women with IDDM during the 12-year period, 1982-93, received their antenatal care from a 'diabetic team' at the County Hospital, Ostersund. There were 50 women in the series, accounting for a total of 91 pregnancies. Spontaneous or induced abortions occurred in 19 cases. Case notes from maternity, neonatal and pediatric care were retrospectively scrutinized. In period one 31% of the pregnancies occurred in gravidae with diabetes classified as White D, F or R, as compared with 46% and 71% during periods two and three (p=0.001). Maternal hypertension was also more frequent in period three (12%, 26% and 54%, respectively; p=0.001). Fewer antenatal admissions (p=0.02) but more frequent ultrasound scannings (p=0.014) were recorded for period three. HbA1c levels decreased continuously from prepregnancy through first and third trimesters (9.7%, 8.4%, and 7.4%, respectively; p<0.0001). Perinatal mortality and frequencies of congenital malformations were both 4.2% (95% CI 0.5-8.8%), whereas the miscar...Continue Reading

Citations

Sep 2, 2006·Obstetrics and Gynecology·Joanne YangKrista Jangaard
Nov 19, 2011·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·James Bernasko
Jun 17, 2005·Birth Defects Research. Part A, Clinical and Molecular Teratology·Jonas Cederberg, Ulf J Eriksson

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