Determinants of a good perinatal outcome in 588 pregnancies in women with type 1 diabetes
| Autor: | C. Le Ray, Danièle Dubois-Laforgue, J. Lepercq, C. Godefroy, José Timsit, L. Pelage |
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| Přispěvatelé: | Université Paris Descartes - Paris 5 (UPD5), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Pregnancy Rate Endocrinology Diabetes and Metabolism [SDV]Life Sciences [q-bio] Population Pregnancy in Diabetics 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Congenital Abnormalities Fetal Macrosomia Preeclampsia Cohort Studies 03 medical and health sciences Shoulder dystocia 0302 clinical medicine Endocrinology Pre-Eclampsia Pregnancy Risk Factors Internal Medicine Humans Medicine education Type 1 diabetes education.field_of_study business.industry Obstetrics Infant Newborn Pregnancy Outcome General Medicine Odds ratio medicine.disease 3. Good health Diabetes Gestational Diabetes Mellitus Type 1 Premature Birth Gestation Female France business Cohort study |
| Zdroj: | Diabetes and Metabolism Diabetes and Metabolism, Elsevier Masson, 2019, 45, pp.191-196. ⟨10.1016/j.diabet.2018.04.007⟩ |
| ISSN: | 1262-3636 |
| Popis: | Aim This study assessed pregnancy outcomes in women with type 1 diabetes (T1D) over the last 15 years and identified modifiable factors associated with good perinatal outcomes. Methods Pregnancy outcomes were prospectively assessed in this cohort study of 588 singleton pregnancies (441 women) managed by standardized care from 2000 to 2014. A good perinatal outcome was defined as the uncomplicated delivery of a normally formed, non-macrosomic, full-term infant with no neonatal morbidity. Factors associated with good perinatal outcomes were identified by logistic regression. Results The rate of severe congenital malformations was 1.5%, and 0.7% for perinatal mortality. The most frequent perinatal complications were macrosomia (41%), preterm delivery (16%) and neonatal hypoglycaemia (11%). Shoulder dystocia occurred in 2.6% of cases, but without sequelae. Perinatal outcomes were good in 254 (44%) pregnancies, and were associated with lower maternal HbA1c values at delivery [adjusted odds ratio (aOR): 2.78, 95% CI: 2.04–3.70, for each 1% (11 mmol/mol) absolute decrease], lower gestational weight gains (aOR: 1.06, 95% CI: 1.02–1.10) and absence of preeclampsia (aOR: 2.63, 95% CI: 1.09–6.25). The relationship between HbA1c at delivery and a good perinatal outcome was continuous, with no discrimination threshold. Conclusion In our study, rates of severe congenital malformations and perinatal mortality were similar to those of the general population. Less severe complications, mainly macrosomia and late preterm delivery, persisted. Also, our study identified modifiable risk factors that could be targeted to further improve the prognosis of pregnancy in T1D. |
| Databáze: | OpenAIRE |
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