Diabetes and pregnancy in Scotland: 15-year observational outcome data from 1998 to 2013

S. T. Mackin, S. M. Nelson, J. J. Kerssens, S. Wild, R. Wood, H. M. Colhoun, G. P. Leese, S. Philip, R. S. Lindsay

Research output: Contribution to journalAbstractpeer-review

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 languageEnglish
Pages (from-to)17-17
Number of pages1
JournalDiabetic Medicine
Volume35
Issue numberS1
Early online date14 Mar 2018
DOIs
Publication statusPublished - Mar 2018

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