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Risk Factor Profile and Pregnancy Outcome in Women with Type 1 and Type 2 Diabetes Mellitus.
MedLine Citation:
PMID:  21219247     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: To assess differences in congenital anomalies, infant mortality, and obstetrical complications as well as risk factors associated with an adverse pregnancy outcome in women with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Methods: This observational study was performed at a university clinic and included a total of 200 singleton pregnancies between January 1995 and December 2006. Outcome measures comprise the prevalence of major congenital malformations, fetal losses, stillbirths, and neonatal deaths as well as the combined end point, adverse pregnancy outcome, and obstetrical complications. Results: Despite changes in prevailing risk factors, the rate of congenital anomalies and embryonic as well as perinatal death was comparable in type 1 diabetic women over time as well as between women with T1DM and T2DM. Outcome measures and risk factor profile were similar in women with preconception and newly diagnosed T2DM. Glycemic control and increased body mass index (BMI) during the first trimester were the strongest predictors of an adverse pregnancy outcome. Hemoglobin A1c (HbA1c) was higher in T1DM than in T2DM but similar in women with T1DM over time. BMI was highest in women with T2DM, followed by T1DM women of the most recent time period. Conclusions: In addition to HbA1c, other risk factors, especially high BMI, strongly influence pregnancy outcome. The higher prevalence of these risk factors in T2DM might compensate for the better glycemic control, resulting in a pregnancy outcome comparable to that of T1DM. Pregnancy outcome in T1DM remained unchanged over time, possibly because of the missing amelioration of HbA1c levels and the increasing BMI.
Authors:
Ammon Handisurya; Dagmar Bancher-Todesca; Edith Schober; Katharina Klein; Karin Tobler; Barbara Schneider; Arnold Pollak; Peter Husslein; Anton Luger; Alexandra Kautzky-Willer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-10
Journal Detail:
Title:  Journal of women's health (2002)     Volume:  -     ISSN:  1931-843X     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159262     Medline TA:  J Womens Health (Larchmt)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Department of Internal Medicine III, Medical University of Vienna , Vienna, Austria .
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