Document Detail

Perinatal mortality in Type 2 diabetes mellitus.
MedLine Citation:
PMID:  10691157     Owner:  NLM     Status:  MEDLINE    
AIMS: In many parts of the world the number of pregnancies in women with Type 2 diabetes mellitus (DM) now exceeds that in women with Type 1 DM, but there are few data published on perinatal mortality in Type 2 DM. This study reports observational data on perinatal mortality in Type 2 DM from a population with a high background rate of this disorder. METHODS: Over a 12-year period (1985-1997) at the Diabetes Clinic at National Women's Hospital, Auckland, there were 434 pregnancies in women with Type 2 DM (256 known and 178 diagnosed with gestational diabetes mellitus (GDM), but confirmed to have Type 2 DM early post-partum), 160 pregnancies in women with Type 1 DM and 932 in women with GDM. Perinatal mortality was classified as either intermediate fetal death (20-28 weeks' gestation), late fetal death (28 weeks' gestation to term) or early neonatal death (up to 1 month post-partum). RESULTS: The perinatal mortality in Type 2DM was 46.1/1,000, significantly higher than the rates for the general population (12.5), Type 1 DM (12.5) and GDM (8.9) (P < 0.0001). Congenital malformations accounted for only 10% of the perinatal mortality. There was a seven-fold increase in the rate of late fetal death and 2.5-fold increase in the rates of intermediate fetal and late neonatal death. Subjects with Type 2 DM were significantly older and more obese than subjects with Type 1 DM, and presented later to the diabetes service. CONCLUSIONS: Perinatal mortality in Type 2 DM is significantly increased, mainly owing to an excess of late fetal death. Maternal factors such as obesity may be important contributors to the high perinatal mortality. Women diagnosed with GDM who have unrecognized Type 2 DM are also at high risk, but perinatal mortality is low in women with milder degrees of glucose intolerance in pregnancy.
T Cundy; G Gamble; K Townend; P G Henley; P MacPherson; A B Roberts
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  17     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-03-13     Completed Date:  2000-03-13     Revised Date:  2004-11-18    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  33-9     Citation Subset:  IM    
Department of Medicine, University of Auckland, New Zealand.
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MeSH Terms
Age Factors
Diabetes Mellitus
Diabetes Mellitus, Type 1*
Diabetes Mellitus, Type 2*
Diabetes, Gestational
Ethnic Groups
Fetal Death / epidemiology*
Gestational Age
Infant Mortality*
Infant, Newborn
New Zealand / epidemiology
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Pregnancy in Diabetics*

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