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Irish Journal of Medical Science (1971 -)

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01-06-2011 | Original Article

Pregnancy in women with Type 1 and Type 2 diabetes in Dublin

Authors: M. Higgins, D. Galvin, F. McAuliffe, M. Coffey, R. Firth, S. Daly, E. Coleman, B. Kinsley, M. Geary, M. Byrne, S. Coulter-Smyth, M. Foley

Published in: Irish Journal of Medical Science (1971 -) | Issue 2/2011

Abstract

Introduction

The Confidential Enquiry into Maternal and Child Health (CEMACH) reported outcomes of pregnancies in women with pre-gestational diabetes (PGDM) in the UK (n = 3,733). This study aimed to compare CEMACH outcomes with PGDM pregnancies in Dublin.

Methods

Retrospective chart review of all PGDM pregnancies. Comparison to CEMACH are shown in brackets.

Results

One hundred and ten PGDM women delivered in Dublin. Thirty (27%) had T2 diabetes (vs. 27%). Fifty-nine (53%) women had a booking HbA1c less than 7% (vs. 66%). Nineteen women (17.3%) had a first trimester miscarriage (vs. 8.5%). Of the 91 remaining women, 71 (78%) women underwent induction of labour (vs. 38.9%). Fifty-four women (59.3%) were delivered by caesarean section (vs. 67.4%). Two infants (2.1%) were macrosomic (vs. 5.7%). There was one intrauterine death (0.1 vs. 0.6%) and no maternal deaths (vs. five).

Conclusion

These results serve to underline the continued importance of multidisciplinary care for pregnant women with diabetes.

Confidential Enquiry into Maternal and Child Health (2005) Pregnancy in women with Type 1 and Type 2 diabetes 2002–2003, England, Wales and Northern Ireland. CEMACH, London

Evers IM, de Valk HW, Mol BW, ter Braak EW, Visser GH (2002) Macrosomia despite good glycemic control in Type 1 diabetic pregnancy; results of a nationwide study in the Netherlands. Diabetologia 45:1484–1489PubMedCrossRef

Russell NE, Holloway P, Quinn S, Foley M, Kelehan P, McAuliffe FM (2008) Cardiomyopathy and cardiomegaly in stillborn infants of diabetic mothers. Pediatr Dev Pathol 11(1):10–14PubMedCrossRef

Higgins MF, Russell NM, Mulcahy CH, Coffey M, Foley ME, McAuliffe FM (2008) Fetal anterior abdominal wall thickness in diabetic pregnancy. Eur J Obstet Gynecol Reprod Biol 140(1):43–47PubMedCrossRef

Hanson U, Persson B (1993) Outcome of pregnancies complicated by type 1 insulin-dependent diabetes in Sweden: acute pregnancy complications, neonatal mortality and morbidity. Am J Perinatol 10:330–333PubMedCrossRef

McAuliffe F, Foley M, Firth R, Drury I, Stronge JM (1999) Outcome of diabetic pregnancy with spontaneous labour after 38 weeks. Ir J Med Sci 168(3):160–163PubMedCrossRef

Pedersen J (1952) Course of diabetes during pregnancy. Acta Endocrinol 9:342–64

Pedersen J, Brandstrup E (1956) Foetal mortality in pregnant diabetics. Lancet 1:607–611CrossRef

Molsted-Pedersen I (2003) The Pedersen legacy. Textbook of diabetes and pregnancy. Martin Dunitz, London, pp 23–29

10.

Molsted-Pedresen I, Damm P (1993) How to organise care for pregnant diabetic patients. In: Mogensen C, Standl E (eds) Concepts for the ideal diabetic clinic. DeGruyter, Berlin, pp 199–214

11.

Hogay Z (1994) Diabetic ketoacidosis in pregnancy: etiology, pathophysiology and management. Clin Obstet Gynecol 37(1):39–49CrossRef

12.

Klein B, Moss S, Klein R (1990) Effect of pregnancy on the progression of diabetic retinopathy. Diabetes Care 13(1):34–40PubMedCrossRef

13.

Diabetes Care and Research in Europe: the Saint Vincent Declaration. Diabet Med 1990;7:360

14.

Cathelineau G (1999) The St Vincent declaration. A long march for significant changes. Diabetes Metab 25(1):5–8PubMed

15.

Confidential Enquiry into Maternal and Child Health (2004) Maternity Services in 2002 for women with type 1 and type 2 diabetes, England, Wales and Northern Ireland. CEMACH: London

16.

Confidential Enquiry into Maternal and Child Health (2007) Diabetes in Pregnancy: are we providing the best care? Findings of a National Enquiry: England, Wales and Northern Ireland. CEMACH: London

17.

Mills J, Simpson J, Driscoll S et al (1988) Incidence of spontaneous miscarriage among normal women and insulin dependent diabetic women whose pregnancies were identified within 21 days of conception. N Eng J Med 319:1617–1623CrossRef

18.

Weintrob N, Karp M, Hod M (1996) Short and long range complications in offspring of diabetic mothers. J Diabetes Complications 10: 294–301

19.

Greene M (1993) Prevention and diagnosis of congenital anomalies in diabetic pregnancies. Clin Perinaol 20:533–547

20.

Health Service Executive/Office of the Nursing and Midwifery Services Director. Guidelines for the management of pre-gestational and gestational diabetes mellitus from pre-conception to the postnatal period. Dublin, 2010

21.

National Service Framework for Diabetes (England) Standards. Department of Health, The Stationary Office: London: 2001

22.

European Surveillance of Congenital Anomalies EUROCAT Report 8: surveillance of congenital anomalies in Europe 1980–1999. University of Ulster, Newtown abbey; 2002

Title: Pregnancy in women with Type 1 and Type 2 diabetes in Dublin
Authors: M. Higgins
D. Galvin
F. McAuliffe
M. Coffey
R. Firth
S. Daly
E. Coleman
B. Kinsley
M. Geary
M. Byrne
S. Coulter-Smyth
M. Foley
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Irish Journal of Medical Science (1971 -) / Issue 2/2011
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-011-0682-8

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Abstract

Introduction

Methods

Results

Conclusion

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