Impact of type 2 diabetes, obesity and glycaemic control on pregnancy outcomes

Abell, Sally K.; Boyle, Jacqueline; Courten, Barbora de; Soldatos, Georgia; Wallace, Euan M.; Zoungas, Sophia; Teede, Helena

doi:10.1111/ajo.12521

Cited by 51 publications

(47 citation statements)

References 23 publications

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“…A fasting BG (FBG) target <5.9 mmol/L is still associated with a 29% macrosomia rate (74,80,81). Recent retrospective data demonstrated that a mean A1C ≥6.0% in pregnant women with type 2 diabetes was associated with increased risk of neonatal complications (preterm birth, neonatal intensive care unit [NICU] admission, neonatal hypoglycemia and jaundice) compared to women with an A1C <6.0% (82). In women with type 1 diabetes and good glycemic control during pregnancy with an A1C of 4.5% to 7.0%, there is still a linear relationship between third trimester A1C and risk of macrosomia (83).…”

Section: Targets Of Glycemic Controlmentioning

confidence: 99%

Diabetes and Pregnancy

Feig¹,

Berger²,

Donovan³

et al. 2018

Canadian Journal of Diabetes

240

169

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All women with pre-existing type 1 or type 2 diabetes should receive preconception care to optimize glycemic control, assess for complications, review medications and begin folic acid supplementation.• All pregnant women without known pre-existing diabetes should be screened for gestational diabetes between 24 to 28 weeks of pregnancy • If you were diagnosed with gestational diabetes during your pregnancy, it is important to:• Breastfeed immediately after birth and for a minimum of 4 months in order to prevent hypoglycemia in your newborn, obesity in childhood, and diabetes for both you and your childConflict of interest statements can be found on page S274.Can J Diabetes 42 (2018) S255-S282

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Section: Targets Of Glycemic Controlmentioning

confidence: 99%

Diabetes and Pregnancy

Feig¹,

Berger²,

Donovan³

et al. 2018

Canadian Journal of Diabetes

240

169

View full text Add to dashboard Cite

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“… Abell, Abell and Shand report on pregnancies ending at 20 or more weeks, or with birthweight 400 g minimum if gestational ageis not known. McElduff's Research Letter does not define perinatal mortality but compares findings with NSW Midwives Database 2002 which uses the same criteria as the previous three studies . Wong, Gunton and Kothari do not define perinatal mortality by gestational age or birthweight. No studies define the greatest infant age up to which death contributes to perinatal mortality, but most imply that data collection is limited to neonatal inpatient death. In addition to reporting all‐cause perinatal mortality as tabulated above, Abell and Kothari report perinatal mortality in the absence of detected congenital malformation. …”

Section: Methodsmentioning

confidence: 82%

“…Internationally, nulliparous women comprised between 16.4% and 67.0% of women with PPDM. Australian studies report between ⅓ and ½ of women with PPDM are nulliparous (see Table and Fig. ), similar to 45% nulliparity among unselected mothers…”

Section: Resultsmentioning

confidence: 99%

“…PNM: perinatal mortality due to all causes, including terminations of pregnancy within specified gestational age. Abell, Abell and Shand report on pregnancies ending at 20 or more weeks, or with birthweight 400 g minimum if gestational ageis not known. McElduff's Research Letter does not define perinatal mortality but compares findings with NSW Midwives Database 2002 which uses the same criteria as the previous three studies .…”

Section: Methodsmentioning

confidence: 99%

“… Fetal anomaly: Kothari and Gunton did not pre‐specify what anomalies would be reported and simply list diagnoses in the text : webbed thumb described as minor and complex cardiac lesion described as major, trisomy 13, retrognathia and encephalocoele Three authors indicate that they report on both minor and major malformations, but do not define or report separately Abell's report on outcomes for women with type 1 diabetes specify the outcome ’major congenital malformation’, but this is not defined in the paper …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy outcomes for women with pre‐pregnancy diabetes mellitus in Australian populations, rural and metropolitan: A review

McCarthy

Williamson

Shub

2018

Aust NZ J Obst Gynaeco

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Background Historically, pre‐pregnancy diabetes (PPDM) is a recognised risk factor for poor pregnancy outcome. Co‐existing pathology and adverse social determinants including rural‐metropolitan inequities in health and healthcare access may confer additional risks. Multidisciplinary care before, during and after pregnancy can improve outcomes for women with PPDM and their infants. The extent to which rural Australian women and their families share in improved outcomes is unknown. We aimed to summarise maternal characteristics and pregnancy outcomes for women with PPDM, including women in rural settings and examine applications of existing clinical guidelines to rural Australian practice. Methods We sought English language population and cohort studies about PPDM using Medline, Embase, PubMed, Australian epidemiological and international clinical practice guidelines. Results Women with PPDM are changing: older, more obese, of lower parity, less likely to smoke, more likely to have type 2 rather than type 1 diabetes and shorter duration of PPDM. Women with PPDM continue to experience excess adverse pregnancy outcomes, including maternal morbidity, complicated birth, perinatal loss, congenital anomalies and mother‐infant separation. On face value, clinical guidelines appear relevant to women living in rural settings but there are only a few, conflicting outcome studies for rural women with PPDM. Conclusions PPDM is changing. A significant minority live in rural locations, and although perinatal mortality/morbidity seems to be improving, it is unclear if this is also true for rural women due to a lack of recent Australian studies. Further research is necessary to achieve excellence everywhere for women with PPDM and their babies.

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