Pre-existing diabetes mellitus and adverse pregnancy outcomes

被引：82
作者：
Hayfaa A Wahabi
Samia A Esmaeil
Amel Fayed
Ghadeer Al-Shaikh
Rasmieh A Alzeidan
机构：
[1] Sheikh Bahmdan of Evidence-Based Healthcare and Knowledge Translation, College of Medicine, King Saud University, Riyadh
[2] King Saud Ben AbdulAziz University for Health Sciences, Riyadh
[3] High Institute of Public Health Alexandria University, Alexandria
[4] Obstetrics and Gynecology Department, College of Medicine, King Saud University, Riyadh
来源：
BMC Research Notes | / 5卷 / 1期
关键词：
Cesarean delivery; Macrosomia; Pre-existing diabetes mellitus; Preterm delivery; Stillbirth;
D O I：
10.1186/1756-0500-5-496
中图分类号：
学科分类号：
摘要：
Background: Pregnancies complicated by pre-existing diabetes mellitus (PDM) are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM. Methods. This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH) during the period of January 1st to the 31 st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period. Results: A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7%) women had PDM. There were 66 (57%) women with type 1 diabetes mellitus (T1DM) and 50 (43%) women with type 2 diabetes mellitus (T2DM). Compared to non-diabetic women those with PDM were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S), OR 2.67, 95% confidence intervals (CI) (1.63-4.32), P < 0.001, or elective C/S, OR 6.73, 95% CI (3.99-11.31), P < 0.001. The neonates of the mothers with PDM were significantly heavier, P < 0.001; and more frequently macrosomic; OR 3.97, 95% CI (2.03-7.65), P = 0.002. They more frequently have APGAR scores <7 in 5minutes, OR 2.61, 95% CI (0.89-7.05), P 0.057 and more likely to be delivered at <37 gestation weeks, OR 2.24, 95% CI (1.37- 3.67), P 0.003. The stillbirth rate was 2.6 times more among the women with PDM; however the difference did not reach statistical significance, P 0.084. Conclusion: PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5min. © 2012Wahabi et al.; licensee BioMed Central Ltd.
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