Perinatal outcomes in type 2 diabetic patients compared with non-diabetic patients matched by body mass index

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 25; no. 6; p. 611
• Main Authors: Knight, Kristin M, Pressman, Eva K, Hackney, David N, Thornburg, Loralei L
• Format: Journal Article
• Language: English
• Published: England 01.06.2012
• Subjects: Adult; Body Mass Index; Case-Control Studies; Cohort Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases - epidemiology; Infant, Newborn, Diseases - etiology; Morbidity; Obesity - complications; Obesity - epidemiology; Obstetric Labor Complications - epidemiology; Obstetric Labor Complications - etiology; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Complications - etiology; Pregnancy in Diabetics - epidemiology; Pregnancy Outcome - epidemiology; Retrospective Studies; Young Adult
• ISSN: 1476-4954
• DOI: 10.3109/14767058.2011.587059

Given that both type 2 diabetes and obesity are associated with adverse pregnancy outcomes and often coexist, we sought to determine if outcomes in type 2 diabetic patients are related to the presence of diabetes or to maternal obesity. This retrospective cohort study examined perinatal outcomes of type 2 diabetic and nondiabetic patients matched by prepregnancy body mass index January 2000 to July 2008. Chi-square, Fisher's exact test, Mann-Whitney U and t-tests were used to compare groups. The association between type 2 diabetes and adverse perinatal outcomes was evaluated through logistic regression with adjustment for potential confounders. 213 pairs of type 2 and non-diabetic patients were compared. Diabetic patients had overall worse composite pregnancy, delivery, fetal, and neonatal outcomes. Specifically, diabetic patients had higher rates of preeclampsia, poly- and oligohydramnios, cesarean delivery, shoulder dystocia, postpartum hemorrhage, preterm delivery, LGA infant, fetal anomaly, and neonatal hypoglycemia, hyperbilirubinemia, RDS, sepsis, intubation, and admission to the NICU. Diabetes remained a significant predictor of adverse delivery, fetal and neonatal composite outcomes when adjusted for confounders in logistic regression. Type 2 diabetic patients have a higher incidence of adverse perinatal outcomes than nondiabetic patients independent of obesity.