Document Detail


High rate of placental infarcts in type 2 compared with type 1 diabetes.
MedLine Citation:
PMID:  22492874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Timing and cause of pregnancy loss differ between type 1 (T1DM) and type 2 diabetes mellitus (T2DM).
OBJECTIVE: The objective of the study was to determine whether placental histology corresponds to differing causes of pregnancy loss in T1DM and T2DM. We hypothesized that placentas from mothers with T2DM would be more likely to demonstrate vascular pathology than those from mothers with T1DM. RESEARCH DESIGN/SETTING/PARTICIPANTS: We reviewed medical histories, pregnancy outcomes, and placental histology of women with pregestational T1DM and T2DM with singleton pregnancies between 2001 and 2009 at a single tertiary care medical center.
MAIN OUTCOME MEASURES: Placental weight, placental dysmaturity, villous maturation, villitis of unclear etiology, and histological evidence of placental infarction were measured.
RESULTS: Ninety-eight placentas were available for review, 53 from T1DM mothers (56%) and 45 from T2DM mothers (46%). Mean age and glycemic control each trimester did not differ between diabetes types. T2DM placentas had a higher prevalence of placental infarcts (22 vs. 6%, P = 0.02) and a lower prevalence of placental dysmaturity (12 vs. 29%, P = 0.05) compared with T1DM; rates differed from those reported in the general population. There was no difference in placental weight, villous maturity, or villitis of unclear etiology between diabetes types.
CONCLUSIONS: There were many similarities in placental histological findings between diabetes types. Still, one in five T2DM placentas displayed histological infarcts, consistent with a vascular, rather than glycemic, etiology of pregnancy complications, whereas T1DM placentas showed signs of abnormal development.
Authors:
Catherine C Beauharnais; Drucilla J Roberts; Deborah J Wexler
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-06
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  97     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-09     Completed Date:  2012-09-26     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1160-4     Citation Subset:  AIM; IM    
Affiliation:
Boston University School of Public Health, Boston, Massachusetts 02118, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Diabetes Mellitus, Type 1 / complications,  epidemiology*
Diabetes Mellitus, Type 2 / complications,  epidemiology*
Diabetes, Gestational / epidemiology
Female
Humans
Infarction / epidemiology*,  etiology
Placenta / blood supply*
Placenta Diseases / epidemiology,  etiology
Pregnancy
Pregnancy Complications, Cardiovascular / epidemiology,  etiology
Pregnancy Outcome / epidemiology
Pregnancy in Diabetics / epidemiology*
Prevalence
Retrospective Studies
Grant Support
ID/Acronym/Agency:
K23 DK 080 228/DK/NIDDK NIH HHS
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