OBJECTIVE: In 1989 the St. Vincent declaration set a five-year target for approximating outcomes of pregnancies in women with diabetes to those of the background population. We investigated and quantified the risk of adverse pregnancy outcomes in pregnant women with type 1 diabetes (T1DM) to evaluate if the goals of the 1989 St. Vincent Declaration have been obtained concerning foetal and neonatal complications. METHODS: Twelve population-based studies published within the last 10 years with in total 14,099 women with T1DM and 4,035,373 women from the background population were identified. The prevalence of four foetal and neonatal complications was compared. RESULTS: In women with T1DM versus the background population, congenital malformations occurred in 5.0% (2.2-9.0) (weighted mean and range) versus 2.1% (1.5-2.9), relative risk (RR) = 2.4, perinatal mortality in 2.7% (2.0-6.6) versus 0.72% (0.48-0.9), RR = 3.7, preterm delivery in 25.2% (13.0-41.7) versus 6.0% (4.7-7.1), RR = 4.2 and delivery of large for gestational infants in 54.2% (45.1-62.5) versus 10.0%, RR = 4.5. Early pregnancy HbA1c was positively associated with adverse pregnancy outcomes. CONCLUSION: The risk of adverse pregnancy outcomes was two to five times increased in women with T1DM compared with the general population. The goals of the St. Vincent declaration have not been achieved.
OBJECTIVE: In 1989 the St. Vincent declaration set a five-year target for approximating outcomes of pregnancies in women with diabetes to those of the background population. We investigated and quantified the risk of adverse pregnancy outcomes in pregnant women with type 1 diabetes (T1DM) to evaluate if the goals of the 1989 St. Vincent Declaration have been obtained concerning foetal and neonatal complications. METHODS: Twelve population-based studies published within the last 10 years with in total 14,099 women with T1DM and 4,035,373 women from the background population were identified. The prevalence of four foetal and neonatal complications was compared. RESULTS: In women with T1DM versus the background population, congenital malformations occurred in 5.0% (2.2-9.0) (weighted mean and range) versus 2.1% (1.5-2.9), relative risk (RR) = 2.4, perinatal mortality in 2.7% (2.0-6.6) versus 0.72% (0.48-0.9), RR = 3.7, preterm delivery in 25.2% (13.0-41.7) versus 6.0% (4.7-7.1), RR = 4.2 and delivery of large for gestational infants in 54.2% (45.1-62.5) versus 10.0%, RR = 4.5. Early pregnancy HbA1c was positively associated with adverse pregnancy outcomes. CONCLUSION: The risk of adverse pregnancy outcomes was two to five times increased in women with T1DM compared with the general population. The goals of the St. Vincent declaration have not been achieved.
Authors: I-Lynn Lee; Elizabeth L M Barr; Danielle Longmore; Federica Barzi; Alex D H Brown; Christine Connors; Jacqueline A Boyle; Marie Kirkwood; Vanya Hampton; Michael Lynch; Zhong X Lu; Kerin O'Dea; Jeremy Oats; H David McIntyre; Paul Zimmet; Jonathan E Shaw; Louise J Maple-Brown Journal: Diabetologia Date: 2020-01-08 Impact factor: 10.122
Authors: Renata H Benjamin; Laura E Mitchell; Mark A Canfield; Adrienne T Hoyt; Dejian Lai; Tunu A Ramadhani; Suzan L Carmichael; Amy P Case; D Kim Waller Journal: Public Health Nutr Date: 2018-10-17 Impact factor: 4.022
Authors: Abdul Shour; Emma Garacci; Anna Palatnik; Aprill Z Dawson; Ronald Anguzu; Rebekah J Walker; Leonard Egede Journal: J Matern Fetal Neonatal Med Date: 2021-01-31
Authors: Debra Bick; Sarah Beake; Lucy Chappell; Khaled M Ismail; David R McCance; James S A Green; Cath Taylor Journal: BMC Pregnancy Childbirth Date: 2014-12-20 Impact factor: 3.007