Maternal and neonatal complications in pregnancies with and without pre-gestational diabetes mellitus
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Rebecca Karkia
Abstract
Objectives
To compare pregnancy complications in pregnancies with and without pre-gestational diabetes mellitus (DM) managed in a multidisciplinary high-risk diabetes antenatal clinic.
Methods
This screening cohort study was undertaken at a large maternity unit in the United Kingdom between January 2010 and December 2022. We included singleton pregnancies that booked at our unit at 11–13 weeks’ gestation. Univariate and multivariate logistic regression analysis was carried out to determine risks of complications in pregnancies with type 1 and type 2 DM after adjusting for maternal and pregnancy characteristics. Effect sizes were expressed as absolute risks (AR) and odds ratio (OR) (95 % confidence intervals [CI]).
Results
The study population included 53,649 singleton pregnancies, including 509 (1.0 %) with pre-existing DM and 49,122 (99.0 %) without diabetes. Multivariate logistic regression analysis demonstrated that there was a significant contribution from pre-existing DM in prediction of adverse outcomes, including antenatal complications such as fetal defects, stillbirth, preterm delivery, polyhydramnios, preeclampsia and delivery of large for gestational age (LGA) neonates; intrapartum complications such as caesarean delivery (CS) and post-partum haemorrhage; and neonatal complications including admission to neonatal intensive care unit, hypoglycaemia, jaundice and hypoxic ischaemic encephalopathy (HIE). In particular, there was a 5-fold increased risk of stillbirth and HIE.
Conclusions
The maternal and neonatal complications in pregnancies with pre-existing DM are significantly increased compared to those without DM despite a decade of intensive multidisciplinary antenatal care. Further research is required to investigate strategies and interventions to prevent morbidity and mortality in pregnancies with pre-gestational DM.
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Ethical approval: The protocol for this study was approved by National Research Ethics Committee (REC reference number 20/HRA/3076).
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Research funding: None declared.
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Supplementary Material
This article contains supplementary material (https://doi.org/10.1515/jpm-2023-0183).
© 2023 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature
- Original Articles – Obstetrics
- Enhanced recovery after cesarean from the patient perspective: a prospective study of the ERAC Questionnaire (ERAC-Q)
- Outcomes of cesarean delivery in placenta accreta: conservative delivery vs. cesarean hysterectomy
- Maternal and neonatal complications in pregnancies with and without pre-gestational diabetes mellitus
- Down-regulated Wnt7a and GPR124 in early-onset preeclampsia placentas reduce invasion and migration of trophoblast cells
- Pregnancy, delivery and neonatal outcomes in women with gastrointestinal system cancer in pregnancy. An evaluation of a population database
- Paternal age and perinatal outcomes: an observational study
- The association between maternal colonization with Group B Streptococcus and infectious morbidity following transcervical Foley catheter-assisted labor induction
- Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis
- Comparison between trans-vaginal and trans-abdominal ultrasound examination of the cervix in the second trimester of pregnancy: a prospective study
- Collaboration between maternal-fetal medicine and family planning: a survey of Northeast US academic medical centers
- Original Articles – Fetus
- Association of low pregnancy associated plasma protein-A with increased umbilical artery pulsatility index in cases of fetal weight between the 3rd and 10th percentiles: a retrospective cohort study
- Genetic analysis, ultrasound phenotype, and pregnancy outcomes of fetuses with Xp22.33 or Yp11.32 microdeletions
- Original Articles – Neonates
- Umbilical cord blood hematological parameters in predicting early onset neonatal sepsis (EOS) – a prospective cohort study
- Changes in circMyt1l/rno-let-7d-5p/brain-derived neurotrophic factor. A damaged periventricular white matter damage model in neonatal rats
- Short Communication
- Effects of gender on fetal cortical development: a secondary analysis of a prospective cross-sectional study
- Acknowledgment
- Acknowledgment
Artikel in diesem Heft
- Frontmatter
- Review
- Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature
- Original Articles – Obstetrics
- Enhanced recovery after cesarean from the patient perspective: a prospective study of the ERAC Questionnaire (ERAC-Q)
- Outcomes of cesarean delivery in placenta accreta: conservative delivery vs. cesarean hysterectomy
- Maternal and neonatal complications in pregnancies with and without pre-gestational diabetes mellitus
- Down-regulated Wnt7a and GPR124 in early-onset preeclampsia placentas reduce invasion and migration of trophoblast cells
- Pregnancy, delivery and neonatal outcomes in women with gastrointestinal system cancer in pregnancy. An evaluation of a population database
- Paternal age and perinatal outcomes: an observational study
- The association between maternal colonization with Group B Streptococcus and infectious morbidity following transcervical Foley catheter-assisted labor induction
- Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis
- Comparison between trans-vaginal and trans-abdominal ultrasound examination of the cervix in the second trimester of pregnancy: a prospective study
- Collaboration between maternal-fetal medicine and family planning: a survey of Northeast US academic medical centers
- Original Articles – Fetus
- Association of low pregnancy associated plasma protein-A with increased umbilical artery pulsatility index in cases of fetal weight between the 3rd and 10th percentiles: a retrospective cohort study
- Genetic analysis, ultrasound phenotype, and pregnancy outcomes of fetuses with Xp22.33 or Yp11.32 microdeletions
- Original Articles – Neonates
- Umbilical cord blood hematological parameters in predicting early onset neonatal sepsis (EOS) – a prospective cohort study
- Changes in circMyt1l/rno-let-7d-5p/brain-derived neurotrophic factor. A damaged periventricular white matter damage model in neonatal rats
- Short Communication
- Effects of gender on fetal cortical development: a secondary analysis of a prospective cross-sectional study
- Acknowledgment
- Acknowledgment
