ATLANTIC DIP: Pregnancy Outcome for Women With Pregestational Diabetes Along the Irish Atlantic Seaboard

Abstract

OBJECTIVEProspective evaluation of pregnancy outcomes in pregestational diabetes along the Atlantic seaboard 2006–2007.RESEARCH DESIGN AND METHODSThe Atlantic Diabetes in Pregnancy group, representing five antenatal centers in a wide geographical location, was established in 2005. All women with diabetes for >6 months before the index pregnancy were included. Results were collected electronically via the DIAMOND Diabetes Information System. Pregnancy outcome was compared with background rates.RESULTSThere were 104 singleton pregnancies. The stillbirth rate (25/1,000) was 5 times, perinatal mortality rate (25/1,000) 3.5 times, and congenital malformation rate (24/1,000) 2 times that of the background population. A total of 28% of women received prepregnancy care, 43% received prepregnancy folic acid, and 51% achieved an A1C ≤7% at first antenatal visit.CONCLUSIONSWomen are not well prepared for pregnancy, and outcomes are suboptimal. A regional prepregnancy care program and centralized glucose management are urgently needed.

Trends in Incidence of Diabetes in Pregnancy and Serious Perinatal Outcomes: A Large, Population-Based Study in Ontario, Canada, 1996–2010

“…This is consistent with other studies that continue to show elevated perinatal mortality rates in women with pre-GDM captured past 2003 (13,14,32). Two studies that looked at the trend over time showed a nonsignificant decline in stillbirths/perinatal mortality (13,14).…”

Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria

“…Established in 2006 following approval from the local ethics board, one of its aims is to determine the prevalence of hyperglycaemia in pregnancy and the associated short-and long-term maternal and fetal outcomes [8,9]. Pregnant women whose last menstrual period occurred between September 2006 and March 2009 were eligible to participate in Atlantic DIP.…”

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

“…The Atlantic Diabetes in Pregnancy (Atlantic DIP) partnership was set up in 2005 and serves a population of 500 000 in five regional centers along the Irish Atlantic seaboard, with 11 000 deliveries annually, covering a geographical area of 7338 square miles (8). This partnership advocates universal screening for GDM by a 2 h 75 g oral glucose tolerance test (OGTT) at 24-28 weeks gestation using International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria.…”

“…All women diagnosed with GDM in an index pregnancy between January 1st 2006 and December 31st 2007 (nZ323) were invited to participate in this study, which is a substudy of GDM patients from the ongoing Atlantic DIP collaboration (8). We also recalled a control group of women who had normal glucose tolerance (NGT) during an index pregnancy during the same time period in the same location.…”