A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes

López‐de‐Andrés, Ana; Pérez-Farinós, Napoleón; Hernández-Barrera, Valentín; Palomar-Gallego, María A.; Carabantes-Alarcón, David; Zamorano-León, José J.; Miguel‐Díez, Javier de; Jiménez‐García, Rodrigo

doi:10.3390/jcm9020582

Cited by 33 publications

(27 citation statements)

References 37 publications

(79 reference statements)

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“…Sixteen studies were retrospective, two were prospective, one was cross-sectional and one was unspecified. Nine studies reported adverse outcomes for pregestational diabetes, combining data for T1DM and T2DM [ 16 , 20 , 22 , 25 , 27 , 43 , 44 , 45 , 46 ], while 11 studies reported data for T1DM and T2DM, separately [ 14 , 15 , 17 , 21 , 24 , 47 , 48 , 49 , 50 , 51 , 52 ]. These studies reported on various maternal and neonatal short-term pregnancy adverse outcomes, of which 13 are summarised in this review.…”

Section: Resultsmentioning

confidence: 99%

“…However, two studies reported no difference in the rates of stillbirths between pregestational diabetes and GDM [ 20 , 45 ]. When comparing T1DM and T2DM separately with GDM, higher rates of stillbirths were reported in pregestational T1DM and T2DM compared to GDM in three studies [ 17 , 24 , 49 ], while Huddle et al, 1993, reported higher rates in T2DM (4.7%) compared to T1DM (3.3%) and GDM (4.0%) with the latter occurring at a similar rate [ 47 ]. Altogether, these results demonstrate that stillbirths are more common in neonates born to mothers with pregestational T1DM and T2DM compared to neonates born to mothers with GDM.…”

Section: Resultsmentioning

confidence: 99%

“…Placental abnormalities and congenital malformations are major risk factors for stillbirth and neonatal death, which represent the extreme end of the spectrum of complications in diabetic pregnancies [ 49 ]. Stillbirth is defined as the death of a foetus at ≥22 weeks of gestation or birth weight of ≥500 g [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

Malaza

Masete

Adam

et al. 2022

IJERPH

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Pregestational type 1 (T1DM) and type 2 (T2DM) diabetes mellitus and gestational diabetes mellitus (GDM) are associated with increased rates of adverse maternal and neonatal outcomes. Adverse outcomes are more common in women with pregestational diabetes compared to GDM; although, conflicting results have been reported. This systematic review aims to summarise and synthesise studies that have compared adverse pregnancy outcomes in pregnancies complicated by pregestational diabetes and GDM. Three databases, Pubmed, EBSCOhost and Scopus were searched to identify studies that compared adverse outcomes in pregnancies complicated by pregestational T1DM and T2DM, and GDM. A total of 20 studies met the inclusion criteria and are included in this systematic review. Thirteen pregnancy outcomes including caesarean section, preterm birth, congenital anomalies, pre-eclampsia, neonatal hypoglycaemia, macrosomia, neonatal intensive care unit admission, stillbirth, Apgar score, large for gestational age, induction of labour, respiratory distress syndrome and miscarriages were compared. Findings from this review confirm that pregestational diabetes is associated with more frequent pregnancy complications than GDM. Taken together, this review highlights the risks posed by all types of maternal diabetes and the need to improve care and educate women on the importance of maintaining optimal glycaemic control to mitigate these risks.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

Malaza

Masete

Adam

et al. 2022

IJERPH

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“…Several studies have separated between the neonatal outcomes of women with different types of preexisting diabetes. In a population-based study of diabetes during pregnancy in Spain (2009–2015), pregestational type 1 diabetes was associated with more severe neonatal morbidity, preterm birth (RR 3.32; 95% CI 3.14–3.51), and fetal overgrowth (RR 8.05; 95% CI 7.41–8.75) [ 24 ].…”

Section: Congenital Malformations and Diabetes In Pregnancymentioning

confidence: 99%

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Ornoy

Becker

Weinstein-Fudim³

et al. 2021

IJMS

160

101

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In spite of the huge progress in the treatment of diabetes mellitus, we are still in the situation that both pregestational (PGDM) and gestational diabetes (GDM) impose an additional risk to the embryo, fetus, and course of pregnancy. PGDM may increase the rate of congenital malformations, especially cardiac, nervous system, musculoskeletal system, and limbs. PGDM may interfere with fetal growth, often causing macrosomia, but in the presence of severe maternal complications, especially nephropathy, it may inhibit fetal growth. PGDM may also induce a variety of perinatal complications such as stillbirth and perinatal death, cardiomyopathy, respiratory morbidity, and perinatal asphyxia. GDM that generally develops in the second half of pregnancy induces similar but generally less severe complications. Their severity is higher with earlier onset of GDM and inversely correlated with the degree of glycemic control. Early initiation of GDM might even cause some increase in the rate of congenital malformations. Both PGDM and GDM may cause various motor and behavioral neurodevelopmental problems, including an increased incidence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Most complications are reduced in incidence and severity with the improvement in diabetic control. Mechanisms of diabetic-induced damage in pregnancy are related to maternal and fetal hyperglycemia, enhanced oxidative stress, epigenetic changes, and other, less defined, pathogenic mechanisms.

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“…Only 2% of the patients in our study had T2DM. However, as there is a concerning trend worldwide ofanincreaseinthe maternal age and prevalence of maternal obesity, there is a justified concern that the prevalence of T2DM in pregnancy may increase in future decades [ 38 ]. The lower prevalence of T2DM among women with diabetes in our study may be due to the lower fertility rates of women with pre-gestational T2DM and its association with obesity and polycystic ovarian syndrome, both contributing to the fertility decrease [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal and Fetal Outcomes among Pregnant Women with Diabetes

Gojnić

Todorović

Stanisavljević

et al. 2022

IJERPH

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The aim of this study was to examine the differences in pregnancy complications, delivery characteristics, and neonatal outcomes between women with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). This study included all pregnant women with diabetes in pregnancy in Belgrade, Serbia, between 2010 and 2020. The total sample consisted of 6737 patients. In total, 1318 (19.6%) patients had T1DM, 138 (2.0%) had T2DM, and 5281 patients (78.4%) had GDM. Multivariate logistic regression with the type of diabetes as an outcome variable showed that patients with T1DM had a lower likelihood of vaginal delivery (OR: 0.73, 95% CI: 0.64–0.83), gestational hypertension (OR: 0.47, 95% CI: 0.36–0.62), higher likelihood of chronic hypertension (OR: 1.88, 95% CI: 1.55–2.29),and a higher likelihood ofgestational age at delivery before 37 weeks (OR: 1.38, 95% CI: 1.18–1.63) compared to women with GDM. Multivariate logistic regression showed that patients with T2DM had a lower likelihood ofgestational hypertension compared to women with GDM (OR: 0.37, 95% CI: 0.15–0.92).Our results indicate that the highest percentage of diabetes in pregnancy is GDM, and the existence of differences in pregnancy complications, childbirth characteristics, and neonatal outcomes are predominantly between women with GDM and women with T1DM.

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A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes

Cited by 33 publications

References 37 publications

A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

A Systematic Review to Compare Adverse Pregnancy Outcomes in Women with Pregestational Diabetes and Gestational Diabetes

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Maternal and Fetal Outcomes among Pregnant Women with Diabetes

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