Document Detail


White's classification of diabetes in pregnancy in the 21st century: is it still valid?
MedLine Citation:
PMID:  20013582     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
White's classification system (WCS) was created 60 years ago to identify diabetic (DM) pregnancies at increased risk for perinatal morbidity and mortality. Our objective was to assess the association between WCS and adverse pregnancy outcome (APO) in contemporary DM pregnancies. We studied diabetic women with singleton pregnancies who delivered at >20 weeks at a single institution over a 1-year period (2007 to 2008). Perinatal outcomes were compared between WCS groups. APO was defined as any of the following: preterm birth <34 weeks, severe preeclampsia, shoulder dystocia, and neonatal respiratory disease. Presence of vascular disease was defined as presence of chronic hypertension, chronic renal insufficiency, retinopathy, coronary artery disease, or prior cerebrovascular event. One hundred ninety-six DM pregnancies met the criteria. No significant differences in APO existed between White's class groups among women with pregestational DM (32.7% class B versus 26.9% class C versus 57.1% class D to F; p = 0.46). Logistic regression revealed that vascular disease was associated with APO (odds ratio = 2.7, 95% confidence interval = 1.2 to 6.2). In our population, presence of vascular disease, rather than WCS, was a better predictor of APO in DM women.
Authors:
Clint M Cormier; Carla A Martinez; Jerrie S Refuerzo; Manju Monga; Susan M Ramin; George Saade; Sean C Blackwell
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-10
Journal Detail:
Title:  American journal of perinatology     Volume:  27     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  349-52     Citation Subset:  IM    
Copyright Information:
Copyright Thieme Medical Publishers.
Affiliation:
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. clint.m.cormier@uth.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Diabetes, Gestational / classification*
Female
Humans
Pregnancy
Pregnancy Outcome*
Pregnancy in Diabetics / classification*

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