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
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OBJECTIVE: To provide perinatal mortality and congenital anomaly rates for babies born to women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland. DESIGN: National population based pregnancy cohort. SETTING: 231 maternity units in England, Wales, and Northern Ireland. PARTICIPANTS: 2359 pregnancies to women with type 1 or type 2 diabetes who delivered between 1 March 2002 and 28 February 2003. MAIN OUTCOME MEASURES: Stillbirth rates; perinatal and neonatal mortality; prevalence of congenital anomalies. RESULTS: Of 2359 women with diabetes, 652 had type 2 diabetes and 1707 had type 1 diabetes. Women with type 2 diabetes were more likely to come from a Black, Asian, or other ethnic minority group (type 2, 48.8%; type 1, 9.1%) and from a deprived area (type 2, 46.3% in most deprived fifth; type 1, 22.8%). Perinatal mortality in babies of women with diabetes was 31.8/1000 births. Perinatal mortality was comparable in babies of women with type 1 (31.7/1000 births) and type 2 diabetes (32.3/1000) and was nearly four times higher than that in the general maternity population. 141 major congenital anomalies were confirmed in 109 offspring. The prevalence of major congenital anomaly was 46/1000 births in women with diabetes (48/1000 births for type 1 diabetes; 43/1000 for type 2 diabetes), more than double that expected. This increase was driven by anomalies of the nervous system, notably neural tube defects (4.2-fold), and congenital heart disease (3.4-fold). Anomalies in 71/109 (65%) offspring were diagnosed antenatally. Congenital heart disease was diagnosed antenatally in 23/42 (54.8%) offspring; anomalies other than congenital heart disease were diagnosed antenatally in 48/67 (71.6%) offspring. CONCLUSION: Perinatal mortality and prevalence of congenital anomalies are high in the babies of women with type 1 or type 2 diabetes. The rates do not seem to differ between the two types of diabetes.
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- Authors
- Macintosh, M. C. M., Fleming, K. M., Bailey, J. A., Doyle, P., Modder, J., Acolet, D., Golightly, S., & Miller, A.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Macintosh, Mary C M
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2006-06-16
- Volume
- 333
- Issue
- 7560
- Pages
- 177
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1513435
- OpenAlex
- W1975469422
- Cited by
- 673
- References
- 29
- Citations by year
- 2026: 15 · 2025: 20 · 2024: 15 · 2023: 19 · 2022: 32 · 2021: 33 · 2020: 18 · 2019: 24 · 2018: 42 · 2017: 89 · 2016: 35 · 2015: 37 · 2014: 28 · 2013: 41 · 2012: 32
- FWCI
- 44.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- 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 › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- type 2 diabetes, perinatal mortality, congenital malformations, stillbirth, neural tube defects, congenital heart disease, prenatal diagnosis, pregnancy outcomes, ethnic minority women, socioeconomic deprivation, pregnancy cohort, England Wales Northern Ireland, diabetes in pregnancy, neonatal mortality
- MeSH terms
- Congenital Abnormalities, Adolescent, Adult, Child, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Gestational Age, United Kingdom, Humans, Infant Mortality, Infant, Newborn, Poverty, Pregnancy, Pregnancy in Diabetics, Pregnancy Outcome, Prevalence, Age of Onset, Stillbirth
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