Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990-2002
Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990-2002
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DOI：
10.1046/j.1464-5491.2003.01017.x
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发表时间：
2003-09-01
影响因子：
3.5
通讯作者：
Gee, H
中科院分区：
文献类型：
--
作者：
Dunne, F;Brydon, P;Gee, H
目的：12年的妊娠结局分析2型糖尿病妇女在一个多民族的地理定义area.Methods的信息，1990年和2002年之间交付的182名妇女从一个区域的计算机数据库中确定。主要的结局指标是流产率，死产，新生儿/产后死亡，先天性畸形，出生体重，分娩方式，新生儿病房护理以及母亲的羊水过多，产后出血，妊娠高血压/先兆子痫的发病率。结果在182例单胎妊娠，161（88%）导致了一个活的结果。有16例（8.8%）自然流产，2例（1.2%）死产，3例（1.6%）终止妊娠。18例（99/1000）发生先天畸形。有两名新生儿早期死亡和一名新生儿晚期死亡，还有两名出生后死亡。28%的婴儿大于胎龄，15（9.3%）大于4公斤。53%通过剖腹产分娩，68例（37%）需要入院接受新生儿病房（NNU）护理。高血压/先兆子痫的两倍，羊水过多的三倍，产后出血6倍，更常见于nondiabetic women.Conclusions 2型糖尿病妇女有一个不太满意的妊娠结局与一般人群相比。与区域/国家数字相比，婴儿死产风险高两倍，围产期死亡风险高2.5倍，出生后第一个月内死亡风险高3.5倍，一岁以下死亡风险高6倍。他们患先天畸形的风险要高出11倍。如果我们要改进，就需要制定更好的教育和筛查战略。
Aim Twelve years' outcome analysis of pregnancies in women with Type 2 diabetes in a multiethnic geographically defined area.Methods Information about 182 women delivered between 1990 and 2002 was ascertained from a regional computerized database. The main outcome measures were rates of miscarriage, stillbirth, neonatal/postnatal deaths, congenital malformations, birth weight, mode of delivery, and neonatal unit care as well as maternal morbidities of polyhydramnios, postpartum haemorrhage, pregnancy-induced hypertension/pre-eclampsia.Results Among 182 singleton pregnancies, 161 (88%) resulted in a live outcome. There were 16 (8.8%) spontaneous miscarriages, two (1.2%) stillbirths, and three (1.6%) terminations. Congenital malformations occurred in 18 pregnancies (99/1000). There were two early and one late neonatal deaths and two further deaths in the postnatal period. Twenty-eight percent of infants were large for gestational age, with 15 (9.3%) greater than 4 kg. Fifty-three percent were delivered by caesarean section and 68 (37%) required admission to neonatal unit (NNU) care. Hypertension/pre-eclampsia was two times, polyhydramnios three times, and postpartum haemorrhage six times more common than in nondiabetic women.Conclusions Women with Type 2 diabetes have a less satisfactory pregnancy outcome compared with the general population. Infants have a two-fold greater risk of stillbirth, a 2.5-fold greater risk of a perinatal mortality, a 3.5-fold greater risk of death within the first month and a six-fold greater risk of death up to 1 year compared with regional/national figures. They have an 11 times greater risk of a congenital malformation. We need to develop better educational and screening strategies if we are to improve.