Pre-existing diabetes mellitus and adverse pregnancy outcomes

BMC Research Notes

Rasmieh A Alzeidan²  Ghadeer Al-Shaikh¹  Amel Fayed³  Samia A Esmaeil²  Hayfaa A Wahabi² 

[1] Obstetrics and Gynecology Department, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia;Sheikh Bahmdan Chair of Evidence-Based Healthcare and Knowledge Translation, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia;High Institute of Public Health Alexandria University, Alexandria, Egypt

关键词: Preterm delivery;    Cesarean delivery;    Stillbirth;    Macrosomia;    Pre-existing diabetes mellitus;   

Others  :  1165739
DOI  :  10.1186/1756-0500-5-496

 received in 2012-04-21, accepted in 2012-08-07,  发布年份 2012

【 摘 要 】

Background

Pregnancies complicated by pre-existing diabetes mellitus (PDM) are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM.

Methods

This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH) during the period of January 1^st to the 31^st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period.

Results

A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7%) women had PDM. There were 66 (57%) women with type 1 diabetes mellitus (T1DM) and 50 (43%) women with type 2 diabetes mellitus (T2DM). Compared to non-diabetic women those with PDM were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S), OR 2.67, 95% confidence intervals (CI) (1.63-4.32), P < 0.001, or elective C/S, OR 6.73, 95% CI (3.99-11.31), P < 0.001. The neonates of the mothers with PDM were significantly heavier, P < 0.001; and more frequently macrosomic; OR 3.97, 95% CI (2.03-7.65), P = 0.002. They more frequently have APGAR scores <7 in 5 minutes, OR 2.61, 95% CI (0.89-7.05), P 0.057 and more likely to be delivered at <37 gestation weeks, OR 2.24, 95% CI (1.37- 3.67), P 0.003. The stillbirth rate was 2.6 times more among the women with PDM; however the difference did not reach statistical significance, P 0.084.

Conclusion

PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5 min.

【 授权许可】

   
2012 Wahabi et al.; licensee BioMed Central Ltd.

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