Diabetes Metab J.  2015 Aug;39(4):316-320. 10.4093/dmj.2015.39.4.316.

Maternal and Neonatal Outcomes in Korean Women with Type 1 and Type 2 Diabetes

• Kim HS
• Jang HJ
• Park JE
• Kim MY
• Ko SY
• Kim SH

• KMID: 2174027
• DOI: http://doi.org/10.4093/dmj.2015.39.4.316

Abstract

BACKGROUND
The purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes.
METHODS
We performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (n=13) and type 2 diabetes (n=150) treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups.
RESULTS
Differences in glycosylated hemoglobin between type 1 and type 2 diabetes were not significant. Birth weight (3,501+/-689.6 g vs. 3,366+/-531.4 g) and rate of major congenital malformations (7.7% vs. 5.6%) were not significantly different. However, women with type 1 diabetes had higher rates of preeclampsia (38.5% vs. 8.2%, P=0.006), large for gestational age (LGA; 46.2% vs. 20.4%, P=0.004), macrosomia (38.5% vs. 13.4%, P=0.032), and admission for neonatal care (41.7% vs. 14.8%, P=0.03) than women with type 2 diabetes.
CONCLUSION
Maternal and neonatal outcomes for women with type 1 diabetes were poorer than for women with type 2 diabetes, especially preeclampsia, LGA, macrosomia and admission to the neonatal intensive care unit.

Keyword

Pregnancy outcome; Type 1 diabetes; Type 2 diabetes

MeSH Terms

Birth Weight
Delivery of Health Care
Female
Gestational Age
Hemoglobin A, Glycosylated
Hospitals, General
Humans
Infant, Newborn
Intensive Care, Neonatal
Korea
Pre-Eclampsia
Pregnancy
Pregnancy Outcome
Retrospective Studies

Reference

1. Dunstan DW, Zimmet PZ, Welborn TA, De Courten MP, Cameron AJ, Sicree RA, Dwyer T, Colagiuri S, Jolley D, Knuiman M, Atkins R, Shaw JE. The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care. 2002; 25:829–834.

2. Confidential Enquiry into Maternal and Child Health. Pregnancy in women with type 1 and type 2 diabetes in 2002-2003, England, Wales and Northern Ireland. London: CEMACH;2005.

3. Balsells M, Garcia-Patterson A, Gich I, Corcoy R. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2009; 94:4284–4291.

4. Macintosh MC, Fleming KM, Bailey JA, Doyle P, Modder J, Acolet D, Golightly S, Miller A. Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ. 2006; 333:177.

5. Brydon P, Smith T, Proffitt M, Gee H, Holder R, Dunne F. Pregnancy outcome in women with type 2 diabetes mellitus needs to be addressed. Int J Clin Pract. 2000; 54:418–419.

6. Cundy T, Gamble G, Townend K, Henley PG, MacPherson P, Roberts AB. Perinatal mortality in type 2 diabetes mellitus. Diabet Med. 2000; 17:33–39.

7. Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005; 28:323–328.

8. Roland JM, Murphy HR, Ball V, Northcote-Wright J, Temple RC. The pregnancies of women with type 2 diabetes: poor outcomes but opportunities for improvement. Diabet Med. 2005; 22:1774–1777.

9. Feig DS, Palda VA. Type 2 diabetes in pregnancy: a growing concern. Lancet. 2002; 359:1690–1692.

10. Persson M, Norman M, Hanson U. Obstetric and perinatal outcomes in type 1 diabetic pregnancies: a large, population-based study. Diabetes Care. 2009; 32:2005–2009.

11. Lechat MF, Dolk H. Registries of congenital anomalies: EUROCAT. Environ Health Perspect. 1993; 101:Suppl 2. 153–157.

12. Feig DS, Razzaq A, Sykora K, Hux JE, Anderson GM. Trends in deliveries, prenatal care, and obstetrical complications in women with pregestational diabetes: a population-based study in Ontario, Canada, 1996-2001. Diabetes Care. 2006; 29:232–235.

13. Cundy T, Slee F, Gamble G, Neale L. Hypertensive disorders of pregnancy in women with type 1 and type 2 diabetes. Diabet Med. 2002; 19:482–489.

14. Murphy HR, Rayman G, Lewis K, Kelly S, Johal B, Duffield K, Fowler D, Campbell PJ, Temple RC. Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial. BMJ. 2008; 337:a1680.

15. Reece EA, Sivan E, Francis G, Homko CJ. Pregnancy outcomes among women with and without diabetic microvascular disease (White’s classes B to FR) versus non-diabetic controls. Am J Perinatol. 1998; 15:549–555.

16. Inkster ME, Fahey TP, Donnan PT, Leese GP, Mires GJ, Murphy DJ. Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: systematic review of observational studies. BMC Pregnancy Childbirth. 2006; 6:30.