Clinical outcomes of pregnancy in women with type 1 diabetes(1).

Full Abstract

OBJECTIVE:To evaluate predictors of neonatal hypoglycemia and macrosomia in 107 consecutive pregnancies in type 1 diabetic women. METHODS:We conducted a case record analysis of singleton type 1 diabetic pregnancies between January 1994 and January 1999 following institution of standardized management. RESULTS:The duration of diabetes in the women was 12.9 +/- 6.8 years, and 44 were primigravidas. The mean HbA1c throughout pregnancy was 7.2 +/- 0.8%. There was no relationship between neonatal blood glucose (checked before the second feed) and HbA1c at any point in pregnancy or mean pregnancy HbA1c (R = 0.20, P >.1). However, there was a negative correlation between neonatal blood glucose and maternal blood glucose during labor (R = -0.33, P <.001). When maternal blood glucose during labor was greater than 8 mM (144 mg/dL), neonatal blood glucose was usually less than 2.5 mM (mean 1.7 +/- 0.4 mM or 31 mg/dL). There was no relationship between mean HbA1c and birth weight (R = 0.02, P >.1) or between maximum insulin dose and birth weight (R = 0.09, P >.1). Fetal abdominal circumference measured by ultrasound at 34 weeks correlated strongly with birth weight (R = 0.72, P <.001). CONCLUSION:Neonatal hypoglycemia correlates with maternal hyperglycemia in labor, not with HbA1c during pregnancy. Macrosomia does not correlate with HbA1c during pregnancy.

Author information

Author/s: Taylor, Roy (R); Lee, Choy (C); Kyne-Grzebalski, D (D); Marshall, S M (SM); Davison, J M (JM);

Affiliation: Department of Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. roy.taylor(-atsign-)ncl.ac.uk

Journal and publication information

Publication Type: Journal Article

Journal: Obstetrics and gynecology (Obstet Gynecol), published in United States. (Language: eng)

Reference: 2002-Apr; vol 99 (issue 4) : pp 537-41

Dates: Created 2002/05/31; Completed 2002/09/03; Revised 2009/10/26;

PMID: 12039106, status: MEDLINE (last retrieval date: 10/26/2009, IMS Date: )

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