Abstract
Aim: Diabetes in pregnancy is associated with adverse outcomes,including macrosomia, operative delivery and stillbirth. We aimed to explore national trends in prevalence of diabetes in pregnancy and associated adverse outcomes.
Methods: We analysed data on all obstetric inpatient delivery episodes (live or stillbirth) from 1 April 1998 to 31 March 2013.Information on mother and baby demographics and obstetric intervention was collected. We cross-referenced to our national diabetes database to identify mothers with Type 1 or Type 2 diabetes.
Results: Of 813,777 deliveries, 4,932 were complicated with pregestational diabetes (69% Type 1 diabetes). Prevalence of Type 1 diabetes increased from 1 in 272 births in 1998/1999 to 1 in 210 in 2012/2013, with a greater increase in Type 2 diabetes (1 in 946 to 1 in 504). Duration of diabetes also increased (12.4 to 14.6 years Type 1 diabetes, 2.6 to 4.8 years Type 2 diabetes; p < 0.001). Maternal smoking decreased (24.1% to 18% Type 1 diabetes, 22% to 14% Type 2 diabetes; p < 0.001), and interestingly was lower than the general population (27.9% to 19.3%). Gestational age at delivery fell from 36.7 to 36.4 weeks in Type 1 diabetes and 38 to 37.1 weeks in Type 2 diabetes. Overall, operative delivery rates were high (68%Type 1 diabetes, 60% Type 2 diabetes) and increased over time. Birth weight trended upwards in Type 1 diabetes (p < 0.001) with an already high mean 1.3 SD above the reference population. Perinatal mortality and stillbirth remained unchanged at 3- to 5-fold above general population
.Conclusions: Diabetes in pregnancy is becoming more prevalent,but outcomes remain similar over the last 15 years. There is a major unmet need to improve outcomes in pregnancy
Original language | English |
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Pages (from-to) | 17-17 |
Number of pages | 1 |
Journal | Diabetic Medicine |
Volume | 35 |
Issue number | S1 |
Early online date | 14 Mar 2018 |
DOIs | |
Publication status | Published - Mar 2018 |