Diabetes and pregnancy in South Carolina: prevalence, perinatal mortality, and neonatal morbidity in 1978.

Through retrospective analysis of vital records and hospital discharge data, this study examines the prevalence of diabetes in pregnancy and diabetes-related perinatal mortality and neonatal morbidity in South Carolina in 1978. Diabetes was observed in 5.9/1000 deliveries. Diabetic natality rates for whites and nonwhites were 5.1/1000 and 6.9/1000, respectively. In comparison with comprehensive screening programs, these rates suggest that more than half of all diabetic pregnancies in South Carolina are unrecognized. The overall diabetic perinatal mortality rate was 102 deaths/1000 deliveries, in contrast to the nondiabetic perinatal mortality rate of 25 deaths/1000 deliveries. The risk of perinatal mortality is greater for nonwhites (153 deaths/1000 deliveries) and for women on insulin (182 deaths/1000 deliveries). One-fourth of the pregnancies among nonwhite women on insulin resulted in fetal or neonatal death. Observed neonatal morbidity was high, with respiratory distress syndrome, hypoglycemia, infections, and congenital anomalies the most frequent complications reported. Documentation of assessment for other common neonatal complications was limited.