OBJECTIVE: To examine changes in perinatal mortality and birth weight of babies born to mothers with pregestational type 1 diabetes over 40 years in a single teaching hospital clinic. METHODS: This was a retrospective survey of cases from the combined diabetes and obstetrics antenatal clinic at the Royal Infirmary of Edinburgh and Simpson Memorial Maternity Pavilion, Edinburgh, Scotland. Birth weight, standardized birth weight, and perinatal mortality were obtained from 643 singleton babies born after 28 weeks of gestation to mothers with pregestational type 1 diabetes between 1960 and 1999. RESULTS: There was a dramatic improvement in perinatal mortality rate, falling from 225 (per 1,000 total births after 28 weeks of gestation) in the 1960s to 102 in the 1970s, 21 in the 1980s, and 10 in the 1990s (P < .001 for effect of birth year). In contrast, standardized birth weight (adjusted for sex, gestational age, and parity), which was significantly higher than the background population (+1.41 standard deviations above the population norm, P < .001) showed no significant change over time. CONCLUSION: Changes in diabetic management and obstetric practice over the 40 years of our survey have resulted in enormous improvements in the outlook for offspring of mothers with diabetes. Somewhat surprisingly this has not been associated with a reduction in overgrowth of the fetus. LEVEL OF EVIDENCE: II-2.
OBJECTIVE: To examine changes in perinatal mortality and birth weight of babies born to mothers with pregestational type 1 diabetes over 40 years in a single teaching hospital clinic. METHODS: This was a retrospective survey of cases from the combined diabetes and obstetrics antenatal clinic at the Royal Infirmary of Edinburgh and Simpson Memorial Maternity Pavilion, Edinburgh, Scotland. Birth weight, standardized birth weight, and perinatal mortality were obtained from 643 singleton babies born after 28 weeks of gestation to mothers with pregestational type 1 diabetes between 1960 and 1999. RESULTS: There was a dramatic improvement in perinatal mortality rate, falling from 225 (per 1,000 total births after 28 weeks of gestation) in the 1960s to 102 in the 1970s, 21 in the 1980s, and 10 in the 1990s (P < .001 for effect of birth year). In contrast, standardized birth weight (adjusted for sex, gestational age, and parity), which was significantly higher than the background population (+1.41 standard deviations above the population norm, P < .001) showed no significant change over time. CONCLUSION: Changes in diabetic management and obstetric practice over the 40 years of our survey have resulted in enormous improvements in the outlook for offspring of mothers with diabetes. Somewhat surprisingly this has not been associated with a reduction in overgrowth of the fetus. LEVEL OF EVIDENCE: II-2.
Authors: Katarzyna Cyganek; Jan Skupien; Barbara Katra; Alicja Hebda-Szydlo; Izabela Janas; Iwona Trznadel-Morawska; Przemysław Witek; Elżbieta Kozek; Maciej T Malecki Journal: Endocrine Date: 2016-10-11 Impact factor: 3.633
Authors: Sharon T Mackin; Scott M Nelson; Joannes J Kerssens; Rachael Wood; Sarah Wild; Helen M Colhoun; Graham P Leese; Sam Philip; Robert S Lindsay Journal: Diabetologia Date: 2018-01-11 Impact factor: 10.122
Authors: Sarit Helman; Tamarra M James-Todd; Zifan Wang; Andrea Bellavia; Jennifer A Wyckoff; Shanti Serdy; Elizabeth Halprin; Karen O'Brien; Tamara Takoudes; Munish Gupta; Thomas F McElrath; Florence M Brown Journal: J Perinatol Date: 2020-06-02 Impact factor: 2.521