Perinatal and infant mortality in term and preterm births among women with type 1 diabetes

Eidem, Ingvild; Vangen, Siri; Hanssen, Kristian F.; Vollset, Stein Emil; Henriksen, Tore; Joner, Geir; Stene, Lars C.

doi:10.1007/s00125-011-2281-7

Cited by 54 publications

(18 citation statements)

References 28 publications

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“…Both pregestational diabetes mellitus and CHDs also increase the risk of stillbirth. 2 However, sensitivity analyses suggested that missing information on CHD in terminated pregnancies did not produce substantial selection bias. Adjustment of the association between CHD and diabetes mellitus for known potential confounders had little effect, and investigating unknown common factors for maternal diabetes mellitus and CHD (inverse examination of CHD and later onset of diabetes mellitus) suggested the absence of strong unknown confounders.…”

Section: Discussionmentioning

confidence: 99%

Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease

et al. 2016

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Background—Maternal diabetes mellitus is associated with an increased risk of offspring congenital heart defects (CHD); however, the causal mechanism is poorly understood. We further investigated this association in a Danish nationwide cohort.Methods and Results—In a national cohort study, we identified 2 025 727 persons born from 1978 to 2011; among them were 7296 (0.36%) persons exposed to maternal pregestational diabetes mellitus. Pregestational diabetes mellitus was identified by using the National Patient Register and individual-level information on all prescriptions filled in Danish pharmacies. Persons with CHD (n=16 325) were assigned to embryologically related cardiac phenotypes. The CHD prevalence in the offspring of mothers with pregestational diabetes mellitus was 318 per 10 000 live births (n=232) in comparison with a baseline risk of 80 per 10 000; the adjusted relative risk for CHD was 4.00 (95% confidence interval, 3.51–4.53). The association was not modified by year of birth, maternal age at diabetes onset, or diabetes duration, and CHD risks associated with type 1 (insulin-dependent) and type 2 (insulin-independent) diabetes mellitus did not differ significantly. Persons born to women with previous acute diabetes complications had a higher CHD risk than those exposed to maternal diabetes mellitus without complications (relative risk, 7.62; 95% confidence interval, 5.23–10.6, and relative risk, 3.49; 95% confidence interval, 2.91–4.13, respectively; P=0.0004). All specific CHD phenotypes were associated with maternal pregestational diabetes mellitus (relative risk range, 2.74–13.8).Conclusions—The profoundly increased CHD risk conferred by maternal pregestational diabetes mellitus neither changed over time nor differed by diabetes subtype. The association with acute pregestational diabetes complications was particularly strong, suggesting a role for glucose in the causal pathway.

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Section: Discussionmentioning

confidence: 99%

Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease

et al. 2016

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“…Fourth, a high birth weight for GA was associated with an increased risk of death by asphyxia and malignant neoplasms. Among high-risk mothers, that is, mothers with high body mass index and/or diabetes,17 18 preferable interventions may be normalised prepregnancy body mass index, minimalised weight gain during pregnancy and improved metabolic control. In lack of effective nutritional and metabolic strategies, asphyxia could possibly be avoided by special attention at delivery in this risk group.…”

Section: Discussionmentioning

confidence: 99%

Cause-specific infant mortality in a population-based Swedish study of term and post-term births: the contribution of gestational age and birth weight

et al. 2012

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ObjectiveTo investigate infant mortality and causes of infant death in relation to gestational age (GA) and birth weight for GA in non-malformed term and post-term infants.DesignObservational, retrospective nationwide cohort study.SettingSweden 1983–2006.Participants2 152 738 singleton non-malformed infants born at 37 gestational weeks or later.Main outcome measuresInfant, neonatal and postneonatal mortality and causes of infant death.ResultsInfant mortality rate was 0.12% (n=2687). Compared with infants born at 40 weeks, risk of infant mortality was increased among early term infants (37 weeks, adjusted OR 1.70, 95% CI 1.43 to 2.02). Compared with infants with normal birth weight for GA, very small for gestational age (SGA; <3rd percentile) infants faced a doubled risk of infant mortality (adjusted OR 2.13, 95% CI 1.80 to 2.53), and corresponding risk was also increased among moderately SGA infants (3rd to <10th percentile; adjusted OR 1.46, 95% CI 1.26 to 1.68). Sudden infant death syndrome (SIDS) was the most common cause of death, accounting for 39% of all infant mortality. Compared with birth at 40 weeks, birth at 37 weeks was associated with increased risks of death by infections, cardiovascular disorders, SIDS and malignant neoplasms. Very and moderately SGA were associated with increased risks of death by neonatal respiratory disorders, infections, cardiovascular disorders, SIDS and neuromuscular disorders. High birth weight for GA was associated with increased risks of death by asphyxia and malignant neoplasms.ConclusionEarly term birth and very to moderately low birth weight for GA are independent risk factors for infant mortality among non-malformed term infants.

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“…Pregnancy in women with type 1 diabetes mellitus (T1DM) is associated with increased maternal and neonatal morbidity and mortality. [1][2][3][4][5][6] In order to minimize risks to both mothers and infants, good interdisciplinary care is required between diabetologists, obstetricians, neonatologists, nursing and allied health professional specialists. Women with T1DM in pregnancy in Ireland are cared for according to 'Adult Type 1 Diabetes Mellitus National Clinical Guideline No.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes in women with onset of type 1 diabetes mellitus less than 18 years of age

Stone

Scully

Troy

et al. 2020

BMJ Open Diab Res Care

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BackgroundPregnancy in women with type 1 diabetes mellitus (T1DM) is associated with an increased risk of congenital malformations, obstetric complications and neonatal morbidity. This study aims to investigate maternal, perinatal and neonatal outcomes of pregnancies in women with onset of T1DM less than 18 years of age.MethodsThis retrospective cohort study extracted data regarding prenatal, intrapartum and postnatal outcomes of pregnancies in women with onset of T1DM<18 years identified from the diabetes in pregnancy register at University Maternity Hospital Limerick, treated from July 1, 2007 to July 1, 2017.ResultsSeventeen women with onset of T1DM <18 years gave birth to 23 live infants during the period studied. 73.9% of pregnancies were unplanned. Only 21.7% of pregnancies took preconceptual folic acid. 60.9% of infants required treatment for hypoglycemia.ConclusionThe high prevalence of unplanned pregnancy and poor uptake of prepregnancy care must be improved on in order to improve outcomes for this high-risk group.

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Perinatal and infant mortality in term and preterm births among women with type 1 diabetes

Cited by 54 publications

References 28 publications

Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease

Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease

Cause-specific infant mortality in a population-based Swedish study of term and post-term births: the contribution of gestational age and birth weight

Pregnancy outcomes in women with onset of type 1 diabetes mellitus less than 18 years of age

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