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Cited by 71Gestational Diabetes Research and ManagementPregnancy and Medication ImpactDiabetes Management and Research

Impact of type 2 diabetes, obesity and glycaemic control on pregnancy outcomes

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Abell, Sally K., Boyle, Jacqueline A., de Courten, Barbora, Soldatos, Georgia, Wallace, Euan M., Zoungas, Sophia, Teede, Helena J.·2017·Australian and New Zealand Journal of Obstetrics and Gynaecology
DOI 10.1111/ajo.12521
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Abstract

BACKGROUND: There are no contemporary cohorts examining pregnancy outcomes in women with type 2 diabetes (T2D) in Australia. AIM: To compare pregnancy outcomes in women with and without T2D, and assess effects of body mass index (BMI) and glycaemic control on outcomes. MATERIALS AND METHODS: An historical cohort study was conducted of all singleton births > 20 weeks gestation at a specialist maternity network in Australia from 2010 to 2013. Data were extracted from the Birthing Outcomes System database. Multivariable logistic regression analysis was used to examine associations between presence of T2D and pregnancy outcomes. RESULTS: Outcomes for 138 pregnancies with T2D and 27 075 pregnancies in women without diabetes were compared (type 1 diabetes and gestational diabetes excluded). Women with T2D were older and more overweight compared to women without diabetes (P < 0.01). Their babies were born earlier (P < 0.01) with increased risk of large for gestational age (adjusted odds ratio 2.13 (95% CI 1.37-3.32)), hypoglycaemia (4.90 (2.79-8.61)), jaundice (2.58 (1.61-4.13)) and shoulder dystocia (2.72 (1.09-6.78)), but not congenital malformations or perinatal death. Women with T2D had a higher risk of induction (4.03 (2.71-5.99)), caesarean section (2.10 (1.44-3.04)), preterm birth (2.74 (1.78-4.24)) and pre-eclampsia (2.75 (1.49-5.10)). An HbA1c ≥ 6.0% (42 mmol/mol) was associated with increased preterm birth, special care nursery admission, hypoglycaemia and jaundice. CONCLUSIONS: Despite availability of preconception care, good glycaemic control and specialist management, T2D remains associated with increased adverse obstetric and neonatal outcomes. Further research to examine predictors of adverse outcomes may assist in targeted antenatal surveillance and management.

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  • In the second and third trimesters, A1C <6% has the lowest risk of large-for-gestational-age infants, preterm delivery, and preeclampsia.

    “In the second and third trimesters, A1C <6% (<42 mmol/mol) has the lowest risk of large-for-gestational-age infants (40,43,44), preterm delivery (45), and preeclampsia (1,46).”

    From 15. Management of Diabetes in Pregnancy: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [45]

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Authors
Abell, S. K., Boyle, J. A., de Courten, B., Soldatos, G., Wallace, E. M., Zoungas, S., & Teede, H. J.
Affiliations
  • Monash Health (AU)
  • Diabetes and Vascular Medicine Unit Monash Health Melbourne Victoria Australia
Corresponding author
Teede, Helena J.
ORCID
Venue
Australian and New Zealand Journal of Obstetrics and Gynaecology
Publisher
Wiley
Published
2016-09-05
Volume
57
Issue
3
Pages
308-314
ISSN
  • 0004-8666 (ISSN-L)
  • 1479-828X
DOI
10.1111/ajo.12521
OpenAlex
W2508859712
Cited by
70
References
23
Citations by year
2026: 3 · 2025: 13 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 2
FWCI
5.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Australian and New Zealand Journal of Obstetrics and Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
  • RMIT Research Repository (RMIT University Library) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes in pregnancy, obesity, body mass index, glycemic control, HbA1c, pregnancy outcomes, preterm birth, large for gestational age, neonatal hypoglycemia, neonatal jaundice, shoulder dystocia, cesarean section, preeclampsia, labor induction, preconception care, antenatal surveillance
MeSH terms
Adult, Australia, Cesarean Section, Diabetes Mellitus, Type 2, Dystocia, Female, Fetal Macrosomia, Glycated Hemoglobin, Humans, Hypoglycemia, Jaundice, Neonatal, Labor, Induced, Male, Obesity, Pre-Eclampsia, Pregnancy, Cohort Studies, Intensive Care, Neonatal, Body Mass Index, Case-Control Studies, Premature Birth, Young Adult

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