Document Detail


The pregnancies of women with Type 2 diabetes: poor outcomes but opportunities for improvement.
MedLine Citation:
PMID:  16401329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To compare the outcomes of Type 1 and Type 2 diabetic pregnancies and identify risk factors for poor outcome of Type 2 pregnancies METHODS: The data from all (389 Type 1 and 146 Type 2) pre-gestational diabetic pregnancies from 10 UK hospitals were collected prospectively. RESULTS: The Type 2 mothers were less likely to have documented pre-pregnancy counselling (28.7 vs. 40.5%; P<0.05) or be taking folic acid at conception (21.9 vs. 36.4%; P<0.001) than Type 1 mothers. The percentage of pregnancies having a serious adverse outcome was higher in Type 2 patients (16.4 vs. 6.4%; P=0.002). Congenital abnormalities (12.3% in Type 2 vs. 4.4% in Type 1; P=0.002) accounted for most of this difference. The HbA1c of the Type 2 patients was similar to that of the Type 1 with mean first trimester HbA1c of 7.22 and 7.35%, respectively (P=0.5). Treatment with oral hypoglycaemic agents [odds ratio (OR), 1.8; 95% confidence interval (CI), 1.0-3.3; P=0.04], body mass index (OR, 1.09; 95% CI, 1.01-1.18; P=0.02) and folic acid supplementation (OR, 0.3; 95% CI, 0.09-1.0; P=0.04) were all independently associated with congenital malformation. CONCLUSION: Type 2 diabetic pregnancies are characterized by poor pre-pregnancy planning, inadequate folic acid supplementation and treatment with oral hypoglycaemic agents, all of which may contribute to the serious adverse outcomes affecting one in six Type 2 diabetic pregnancies. These remediable aspects of the pre-pregnancy care of women with Type 2 diabetes provide opportunities for improving the outcome towards that of women with Type 1 diabetes.
Authors:
J M Roland; H R Murphy; V Ball; J Northcote-Wright; R C Temple
Related Documents :
6356879 - Reference values for the oral glucose tolerance test at each trimester of pregnancy.
15787669 - Effect of maternal diabetes on phosphorylation of insulin-like growth factor binding pr...
23080479 - Maternal use of ssris, snris and nassas: practical recommendations during pregnancy and...
24016809 - Risks and safety of pandemic h1n1 influenza vaccine in pregnancy: birth defects, sponta...
18067529 - Arabidopsis eif3e is regulated by the cop9 signalosome and has an impact on development...
7904949 - Poor glycemic control and antepartum obstetric complications in women with insulin-depe...
21272989 - Cervical hydatidiform mole pregnancy after missed abortion presenting with severe vagin...
9166329 - False-positive diagnosis of spina bifida in a fetus with triploidy.
10901109 - Male-mediated spontaneous abortion among spouses of stainless steel welders.
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  22     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-10     Completed Date:  2006-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1774-7     Citation Subset:  IM    
Affiliation:
Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, and Norwich University, UK. jonathan.roland@pbh-tr.nhs.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Diabetes Mellitus, Type 1 / complications,  therapy*
Diabetes Mellitus, Type 2 / complications,  therapy*
Female
Fetal Death
Fetus / abnormalities
Hemoglobin A, Glycosylated
Humans
Pregnancy
Pregnancy Outcome*
Pregnancy in Diabetics / therapy*
Prenatal Care / standards*
Prospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  No evidence of diabetes-specific CD38 (ADP ribosil cyclase/cyclic ADP-ribose hydrolase) autoantibodi...
Next Document:  IT-adoption and the interaction of task, technology and individuals: a fit framework and a case stud...