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Clinical outcomes of pregnancy in women with type 1 diabetes

Lookup NU author(s): Professor Roy Taylor, Professor Sally Marshall, Emeritus Professor John Davison

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Abstract

OBJECTIVE: To evaluate predictors of neonatal hypoglycemia and macrosomia in 107 consecutive pregnancies in type 1 diabetic women. METHODS: We conducted a case record analysis of singleton type 1 diabetic pregnancies between January 1994 and January 1999 following institution of standardized management. RESULTS: The duration of diabetes in the women was 12.9 +/- 6.8 years, and 44 were primigravidas. The mean HbA1c throughout pregnancy was 7.2 +/- 0.8%. There was no relationship between neonatal blood glucose (checked before the second feed) and HbA1c at any point in pregnancy or mean pregnancy HbA1c (R = 0.20, P > .1). However, there was a negative correlation between neonatal blood glucose and maternal blood glucose during labor (R = -0.33, P < .001). When maternal blood glucose during labor was greater than 8 mM (144 mg/dL), neonatal blood glucose was usually less than 2.5 mM (mean 1.7 +/- 0.4 mM or 31 mg/dL). There was no relationship between mean HbA1c and birth weight (R = 0.02, P > .1) or between maximum insulin dose and birth weight (R = 0.09, P > .1). Fetal abdominal circumference measured by ultrasound at 34 weeks correlated strongly with birth weight (R = 0.72, P < .001). CONCLUSION: Neonatal hypoglycemia correlates with maternal hyperglycemia in labor, not with HbA1c during pregnancy. Macrosomia does not correlate with HbA1c during pregnancy. (C) 2002 by the American College of Obstetricians and Gynecologists.


Publication metadata

Author(s): Taylor R, Lee C, Kyne-Grzebalski D, Marshall SM, Davison JM

Publication type: Article

Publication status: Published

Journal: Obstetrics and Gynecology

Year: 2002

Volume: 99

Issue: 4

Pages: 537-541

ISSN (print): 0029-7844

ISSN (electronic): 1873-233X

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1016/S0029-7844(01)01790-2

DOI: 10.1016/S0029-7844(01)01790-2


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