The role of modifiable pre-pregnancy risk factors in preventing adverse fetal outcomes among women with type 1 and type 2 diabetes

Melanie E Inkster, Tom P Fahey, Peter T Donnan, Graham P Leese, Gary J Mires, Deirdre J Murphy

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

We investigated the fetal outcomes of pregnancy in women with pre-existing diabetes in relation to pre-pregnancy risk factors using a community-based cohort of women in Tayside, Scotland. There were 211 pregnancies in 132 women with insulin-requiring type 1 and 2 diabetes between January 1993 and December 2005. Adverse fetal outcome was classified as spontaneous miscarriage, termination for medical reasons, stillbirth, neonatal death, or congenital malformation and occurred in 61 (29%) pregnancies. Mothers with poor glycemic control pre-conceptually and at booking (HbA(1c)=7.5%) had almost a three-fold increase in adverse fetal outcome compared with mothers having fair control, odds ratio (OR) 2.59 (95% CI 1.11-6.03), and 2.71 (95% CI 1.39-5.28), respectively. Mothers who were still smoking at the booking visit had a two-fold increase in adverse fetal outcome (OR 2.12, 95% CI 1.09-4.10). Further improvement in the management of diabetes and pregnancy is needed through enhanced preconception services addressing the full spectrum of modifiable risk factors.
Original languageEnglish
Pages (from-to)1153-1157
Number of pages5
JournalActa Obstetricia et Gynecologica Scandinavica
Volume88
Issue number10
DOIs
Publication statusPublished - Oct 2009

Keywords

  • adverse fetal outcome
  • cohort study
  • pre-existing diabetes
  • pre-pregnancy risk factors

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