Literature DB >> 23302725

Maternal factors predictive of first‑trimester pregnancy loss in women with pregestational diabetes.

Paweł Gutaj1, Agnieszka Zawiejska, Ewa Wender-Ożegowska, Jacek Brązert.   

Abstract

INTRODUCTION: Diabetes is one of the most frequent chronic diseases in women of childbearing age, which significantly increases the risk of complications at every stage of pregnancy.
OBJECTIVES: The aim of the study was to investigate any maternal factors that may be associated with the risk of first‑trimester pregnancy loss in patients with pregestational diabetes. PATIENTS AND METHODS: It was a retrospective study based on the data of 91 diabetic women in singleton pregnancy and with good perinatal outcome (74 women [81.3%] with type 1 and 17 [18.7%] with type 2 diabetes), and 60 diabetic women with a miscarriage (48 women [80%] with type 1 and 12 [20%] with type 2 diabetes). We analyzed selected maternal parameters at the first admission to the obstetrics department.
RESULTS: Women in the miscarriage group were older compared with those in the good outcome group (29.5 ±5.4 years vs. 26.4 ±5.3 years; P <0.001). Hemoglobin A1c (HbA1c) was higher in the miscarriage group compared with the good outcome group (8.2% ±1.9% vs. 7.2% ±1.8%; P <0.001). In a stepwise logistic regression analysis, maternal age at booking and HbA1c were found to be significant predictors of miscarriage (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18 and OR, 1.28; 95% CI, 1.026-1.61; respectively). A statistically insignificant trend towards first-trimester pregnancy loss was observed in patients with hypertension, overweight/obesity, unplanned pregnancy, longer duration of diabetes, and diabetic vascular complications.
CONCLUSIONS: Suboptimal metabolic control and increasing maternal age are the most significant risk factors for first‑trimester miscarriage in women with pregestational diabetes.

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Year:  2013        PMID: 23302725     DOI: 10.20452/pamw.1585

Source DB:  PubMed          Journal:  Pol Arch Med Wewn


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