Risk factors for pregnancy outcomes in type 1 and type 2 diabetes.

Abstract

Our aim was to explore differences in pregnancy outcomes between women with type 1 and type 2 diabetes, and healthy controls, and to examine the relationships between potential adverse risk factors and pregnancy outcomes in this cohort of women. This is a 10 year retrospective study of women with type 1 diabetes (n = 92), type 2 diabetes (n = 106) and healthy women without diabetes (controls) (n = 119) from a tertiary obstetric centre. Clinical and biochemical characteristics of women with type 1 and type 2 diabetes were determined and related to major obstetric outcomes using univariate analysis. Women with pre-existing diabetes had higher adverse pregnancy outcomes (preeclampsia, emergency caesarean section, preterm birth <32 and 37 weeks, large for gestational age, neonatal jaundice, Apgar score < 7 at 5 min, neonatal intensive care admission and neonatal hypoglycaemia) compared to controls. A higher birth weight gestational centile (97.4% vs. 72.4%, P = 0.001) and large for gestational age rate (63.4% vs. 35.8%, P = 0.001) were observed in type 1 diabetes compared to type 2 diabetes. There were no differences in other outcomes between women with type 1 and 2 diabetes. In this exploratory study, risk factors for maternal adverse outcomes differ between type 1 and type 2 diabetes. Maternal and fetal adverse outcomes were higher in pregnancies affected by diabetes compared to healthy women but occurred with similar frequency in women with type 1 and type 2 diabetes. This article is protected by copyright. All rights reserved.