Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden

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Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden

Stogianni, Anna (author): Lund University,Lunds universitet,Diabetes lab,Forskargrupper vid Lunds universitet,Lund University Research Groups,Växjö Central Hospital,Skåne University Hospital

Lendahls, Lena (author): Linnaeus University,Linnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Region Kronoberg, Sweden

Landin-Olsson, Mona (author): Lund University,Lunds universitet,Diabetes lab,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital

Thunander, Maria (author): Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Region Kronoberg,Växjö Central Hospital

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2019-05-07
2019
English.
In: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 19

Related links:: https://doi.org/10.1...; show more...; https://bmcpregnancy...; http://dx.doi.org/10... (free); https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BackgroundDiabetes during pregnancy is an increasingly common metabolic disorder, associated with significantly increased risks for both mother and child. Aim of this study was to compare maternal and perinatal outcomes in women with pregestational (PDM) type 1 (T1DM), type 2 diabetes (T2DM), gestational diabetes mellitus (GDM) and compare these to pregnancies not complicated with diabetes. This study also evaluated a specifically organized care-model mostly involving specialist diabetes nurses.MethodsRetrospective population-based records review 2009-2012. Rates of maternal (preeclampsia, pre-term delivery, cesarean section (CS)) and fetal outcomes (large for gestational age (LGA), macrosomia, congenital malformations/intrauterine death) were assessed and potential predisposing or contributing factors as maternal age, ethnicity, obesity, weight gain, parity, HbA1c levels, insulin types and doses.ResultsAmong 280 pregnancies 48 were PDM, 97 GDM and 135 without diabetes. Within the group with diabetes, early-pregnancy BMI was higher (p=0.0001), pregnancy weight gain lower (11.16.7kg vs 13.1 +/- 7.1kg, p=0.005), more delivered preterm (p=0.0001), by CS (p=0.05), and had more LGA neonates (p=0.06) than the group without diabetes. Among pregnancies with diabetes, GDM mothers gained less weight (9.9kg vs 13.5kg) (p=0.006), and rates of CS (p=0.03), preterm deliveries (p=0.001) and LGA (p=0.0001) were not increased compared to PDM; More T1DM infants were LGA, 60% vs. 27% in T2DM. In pregnancies with diabetes obesity, excessive weight gain and multiparity were associated with increased risk of LGA neonates, and mother's type of diabetes and gestational week were associated with higher rates of CS.Conclusion p id=Par4 Weight gain during pregnancy was lower in pregnancies with diabetes and prevalence of LGA, CS and preterm deliveries in GDM was not elevated, also for T2DM, except increased prevalence of LGA in T1DM that warrants increased clinical attention, indicating that this model of antenatal diabetes care may have contributed to improved maternal and fetal outcomes.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

Keyword

Pregestational diabetes
Type 1 diabetes
Type 2 diabetes
Gestational diabetes
Cesarean section
HbA1c
Insulin
Health and Caring Sciences
Hälsovetenskap
Cesarean section
Gestational diabetes
HbA1c
Insulin
Pregestational diabetes
Type 1 diabetes
Type 2 diabetes

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ref (subject category)
art (subject category)

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By the author/editor: Stogianni, Anna; Lendahls, Lena; Landin-Olsson, M ...; Thunander, Maria

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Nursing

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Endocrinology an ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Obstetrics Gynae ...

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By the university: Linnaeus University; Lund University

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