Outcome of pregnancy complicated by pre‐gestational diabetes – improvement in outcomes

Abstract

It is important to continue improving pre-pregnancy planning. Extensive discussions involving a multi-disciplinary team improved planning rates and decreased the LSCS rate while maintaining outcomes.

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

“…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.…”

“… 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 …”

Preconception Counseling and Type 2 Diabetes

“…Gunton et al 5 reported a later gestational age at delivery in women who had PC (38.2 weeks vs. 36.2 weeks, P = 0.0318), whereas Willhoite et al 8 found no significant difference. Gunton et al 4,5 found significantly lower rates of cesarean section in women who had PC (13.6 vs. 48%, P < 0.05; 31.6 vs. 72.7%, P = 0.0295), and GarciaPatterson et al 10 found a significantly higher rate of cesarean section in women who had PC (71 vs. 54.9%, P < 0.05).…”

“…Gunton et al 4,5 found significantly lower rates of cesarean section in women who had PC (13.6 vs. 48%, P < 0.05; 31.6 vs. 72.7%, P = 0.0295), and GarciaPatterson et al 10 found a significantly higher rate of cesarean section in women who had PC (71 vs. 54.9%, P < 0.05). Willhoite et al 8 also reported a higher cesarean section rate in women who received PC (81 vs. 66%) that did not reach statistical significance.…”

“…Gunton et al 5 found a lower rate of large-for-gestational-age (LGA) infants in women who had PC (26.3 vs. 36.4%), whereas Garcia-Patterson et al 10 found a higher rate of LGA infants in women who had PC (33.9 vs. 25.2%, not significant) and a lower rate of small-for-gestational-age babies in women who had PC (1.8 vs. 8.7%, P < 0.05). Willhoite et al 8 found no significant difference in birth weight.…”