Adverse pregnancy outcomes in women with type 1 or type 2 diabetes

In The Lancet Diabetes & Endocrinology, Helen Murphy and colleagues report results of an analysis of 5 years of data from the National Pregnancy in Diabetes (NPID) audit from 172 maternity clinics in England, Wales, and the Isle of Man. 1 Murphy HR Howgate C O'Keefe J et al. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021; (published online Jan 28.)https://doi.org/10.1016/S2213-8587(20)30406-X Summary Full Text Full Text PDF Scopus (14) Google Scholar Their dataset includes data for 17 375 pregnancies in women with diabetes between 2014 and 2018, including 8690 (50·0%) in women with type 1 diabetes and 8685 (50·0%) in women with type 2 diabetes. Overall, the rates of preterm delivery and low-for-gestational-age birthweight were higher in mothers with type 1 diabetes, whereas prevalence of congenital anomaly and stillbirth did not differ between diabetes types, and rates of neonatal death were higher in mothers with type 2 diabetes. Independent risk factors for perinatal death (stillbirth or neonatal death) were increased third trimester HbA1c, high degree of deprivation, and type 2 diabetes. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort studyOur data highlight persistent adverse pregnancy outcomes in women with type 1 or type 2 diabetes. Maternal glycaemia and BMI are the key modifiable risk factors. No maternity clinics were had appreciably better outcomes than any others, suggesting that health-care system changes are needed across all clinics. Full-Text PDF