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. 2006 Jul 22;333(7560):177.
doi: 10.1136/bmj.38856.692986.AE. Epub 2006 Jun 16.

Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study

Mary C M Macintosh  1 , Kate M Fleming, Jaron A Bailey, Pat Doyle, Jo Modder, Dominique Acolet, Shona Golightly, Alison Miller
Affiliations

Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study

Mary C M Macintosh et al. BMJ. .

Abstract

Objective: To provide perinatal mortality and congenital anomaly rates for babies born to women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland.

Design: National population based pregnancy cohort.

Setting: 231 maternity units in England, Wales, and Northern Ireland.

Participants: 2359 pregnancies to women with type 1 or type 2 diabetes who delivered between 1 March 2002 and 28 February 2003.

Main outcome measures: Stillbirth rates; perinatal and neonatal mortality; prevalence of congenital anomalies.

Results: Of 2359 women with diabetes, 652 had type 2 diabetes and 1707 had type 1 diabetes. Women with type 2 diabetes were more likely to come from a Black, Asian, or other ethnic minority group (type 2, 48.8%; type 1, 9.1%) and from a deprived area (type 2, 46.3% in most deprived fifth; type 1, 22.8%). Perinatal mortality in babies of women with diabetes was 31.8/1000 births. Perinatal mortality was comparable in babies of women with type 1 (31.7/1000 births) and type 2 diabetes (32.3/1000) and was nearly four times higher than that in the general maternity population. 141 major congenital anomalies were confirmed in 109 offspring. The prevalence of major congenital anomaly was 46/1000 births in women with diabetes (48/1000 births for type 1 diabetes; 43/1000 for type 2 diabetes), more than double that expected. This increase was driven by anomalies of the nervous system, notably neural tube defects (4.2-fold), and congenital heart disease (3.4-fold). Anomalies in 71/109 (65%) offspring were diagnosed antenatally. Congenital heart disease was diagnosed antenatally in 23/42 (54.8%) offspring; anomalies other than congenital heart disease were diagnosed antenatally in 48/67 (71.6%) offspring.

Conclusion: Perinatal mortality and prevalence of congenital anomalies are high in the babies of women with type 1 or type 2 diabetes. The rates do not seem to differ between the two types of diabetes.

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Comment in

  • Diabetes and pregnancy.
    Macfarlane A, Tuffnell D. Macfarlane A, et al. BMJ. 2006 Jul 22;333(7560):157-8. doi: 10.1136/bmj.333.7560.157. BMJ. 2006. PMID: 16858018 Free PMC article. No abstract available.
  • Why do poor outcomes persist in diabetic pregnancy?
    Cundy T. Cundy T. BMJ. 2006 Aug 5;333(7562):304. doi: 10.1136/bmj.333.7562.304-a. BMJ. 2006. PMID: 16888313 Free PMC article. No abstract available.

References

    1. Evers IM, de Valk HW, Visser GHA. Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands. BMJ 2004;328: 915-9. - PMC - PubMed
    1. Jensen DM, Damm P, Moelsted-Pedersen L, Ovensen P, Westergaard JG, Moeller M, et al. Outcomes in type 1 diabetic pregnancies. Diabetes Care 2004;27: 2819-23. - PubMed
    1. Suhonen L, Hiilesmaa V, Teramo K. Glycaemic control during early pregnancy and fetal anomalies in women with type 1 diabetes mellitus. Diabetologia 2000;43: 79-82. - PubMed
    1. Penney GC, Mair G, Pearson DW. Outcomes of pregnancies in women with type 1 diabetes in Scotland: a national population based study. Br J Obstet Gynaecol 2003;110: 315-8. - PubMed
    1. Department of Health. National service framework for diabetes (England) standards. London: Stationery Office, 2001.

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