Cited by 486Gestational Diabetes Research and ManagementPregnancy and Medication ImpactDiabetes Management and Research

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Outcomes in Type 1 Diabetic Pregnancies

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Jensen, Dorte M., Damm, Peter, Moelsted-Pedersen, Lars, Ovesen, Per, Westergaard, Jes G., Moeller, Margrethe, Beck-Nielsen, Henning·2004·Diabetes Care

DOI 10.2337/diacare.27.12.2819

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Abstract

OBJECTIVE—The aim of this study was to compare pregnancy outcomes in type 1 diabetic pregnancies with the background population. RESEARCH DESIGN AND METHODS—This nationwide prospective multicenter study took place in eight Danish centers treating pregnant women with type 1 diabetes during 1993–1999. A total of 990 women with 1,218 pregnancies and delivery after 24 weeks (n = 1,215) or early termination due to severe congenital malformations (n = 3) were included. Data were collected prospectively by one to three caregivers in each center and reported to a central registry. RESULTS—The perinatal mortality rate was 3.1% in type 1 diabetic pregnancies compared with 0.75% in the background population (RR 4.1 [95% CI 2.9–5.6]), and the stillbirth rate was 2.1% compared with 0.45 (4.7 [3.2–7.0]). The congenital malformation rate was 5.0% in the study population and 2.8% (1.7 [1.3–2.2]) in the background population. Six of the perinatal deaths (16%) were related to congenital malformations. Only 34% of women performed daily home monitoring of blood glucose at conception, and 58% received preconceptional guidance. Pregnancies with serious adverse outcomes (perinatal death and/or congenital malformations) were characterized by higher HbA1c values before and during pregnancy and a lesser degree of maternal self-care and preconceptional guidance. Women who performed daily self-monitoring of blood glucose at any time during pregnancy had lower HbA1c values than women who did not measure their daily profile. Likewise, daily self-monitoring was associated with a reduction in serious adverse outcomes. The caesarean section rate was 55.9 and 12.6%, respectively, and the risk of preterm delivery was 41.7 and 6.0%, respectively. CONCLUSIONS—Type 1 diabetic pregnancies are still complicated by considerably higher rates of severe perinatal complications compared with the background population, and women with poor self-care are at the highest risk. Adequate glycemic control using daily glucose monitoring before and during pregnancy is a crucial step toward reaching the goals of the St. Vincent declaration.

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Elevated Maternal Hemoglobin A1Cin Early Pregnancy and Major Congenital Anomalies in Infants of Diabetic Mothers
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Authors: Jensen, D. M., Damm, P., Moelsted-Pedersen, L., Ovesen, P., Westergaard, J. G., Moeller, M., & Beck-Nielsen, H.
Affiliations: Odense University Hospital (DK)
University of Copenhagen (DK)
Department of Obstetrics and Gynaecology, Copenhagen County Hospital, Glostrup, University of Copenhagen, Copenhagen, Denmark
Aarhus University Hospital (DK)
University of Southern Denmark (DK)
Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
Department of Endocrinology, Odense University Hospital, Odense, Denmark
ORCID: Damm, Peter
Ovesen, Per
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2004-12-01
Volume: 27
Issue: 12
Pages: 2819-2823
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.27.12.2819
OpenAlex: W1978110501
Cited by: 486
References: 14
Citations by year: 2026: 9 · 2025: 6 · 2024: 16 · 2023: 12 · 2022: 16 · 2021: 18 · 2020: 15 · 2019: 17 · 2018: 19 · 2017: 74 · 2016: 21 · 2015: 17 · 2014: 23 · 2013: 28 · 2012: 27
FWCI: 17.64
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, other-oa)
Funders: Diabetesforeningen
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 1 diabetes in pregnancy, perinatal mortality, stillbirth, congenital malformations, glycemic control, HbA1c, self-monitoring of blood glucose, maternal self-care, cesarean section, preterm birth, St. Vincent Declaration
MeSH terms: Congenital Abnormalities, Denmark, Female, Gestational Age, Humans, Infant, Newborn, Jaundice, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Respiratory Distress Syndrome, Newborn, Diabetes, Gestational, Diabetes Complications

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Outcomes in Type 1 Diabetic Pregnancies

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