Differing causes of pregnancy loss in type 1 and type 2 diabetes
Differing causes of pregnancy loss in type 1 and type 2 diabetes
复制标题
DOI：
10.2337/dc07-0555
复制
发表时间：
2007-10-01
期刊：
影响因子：
16.2
通讯作者：
Rowan, Janet
中科院分区：
文献类型：
--
作者：
Cundy, Tim;Gamble, Greg;Rowan, Janet
目的：2型和I型糖尿病妇女流产的危险因素不同。我们比较了I型和2型diabetes.RESEARCH设计和METHODS -我们利用前瞻性收集的数据在20年期间（1986-2005年）从一个单一的中心与2型糖尿病的高患病率的所有怀孕妇女的妊娠丢失率和原因。妊娠损失包括因医疗原因终止妊娠和产后1个月内的死亡，但不包括妊娠< 20周的自发妊娠损失。结果-已知患有糖尿病的女性中有870例怀孕（330例患有I型糖尿病，540例患有2型糖尿病），325例在怀孕期间诊断出糖尿病但产后持续存在（97%为2型糖尿病）。1型和2型糖尿病患者的妊娠丢失率相似（2.6 vs. 3.71/o，P = 0.39），但妊娠丢失的原因不同。在I型糖尿病中> 75%归因于主要先天畸形或早产;在2型糖尿病中>75%归因于死产或绒毛膜羊膜炎（P = 0.017）。女性2型糖尿病患者与I型糖尿病患者在发病时和近期的A1 C相似，但前者年龄较大（P < 0. 05）。00 1）和肥胖（P < 0. 01）。结论：I型和2型糖尿病妇女流产的主要原因存在显著差异。2型糖尿病妇女的死胎率较高，这表明其他特征，如肥胖，对妊娠损失有很大影响。
OBJECTIVE - Women with type 2 and type I diabetes have differing risk factors for pregnancy loss. We compared the rates and causes of pregnancy loss in women with type I and type 2 diabetes.RESEARCH DESIGN AND METHODS - We utilized prospectively collected data on all pregnancies in a 20-year period (1986-2005) from a single center with a high prevalence of type 2 diabetes. Pregnancy losses included terminations for medical reasons and deaths up to 1 month postpartum but not spontaneous pregnancy losses < 20 weeks' gestation.RESULTS - There were 870 pregnancies in women with known diabetes (330 with type I and 540 with type 2 diabetes) and 325 in women with diabetes diagnosed in pregnancy but persisting postpartum (97% type 2 diabetes). The rate of pregnancy loss was similar in type 1 and type 2 diabetes (2.6 vs. 3.71/o, P = 0,39), but the causes of pregnancy loss differed. In type I diabetes > 75% were attributable to major congenital anomalies or prematurity in type 2 diabetes >75% were attributable to stillbirth or chorioammonitis (P = 0.0 17). Women with type 2 and type I diabetes had similar A1C at presentation and near term, but the former were older (P < 0. 00 1) and more obese (P < 0. 000 1).CONCLUSIONS - There are significant differences in the main causes of pregnancy loss in women with type I and type 2 diabetes. The higher rates of stillbirth in women with type 2 diabetes, suggest that other features, such as obesity, contribute significantly to pregnancy losses.