Audit on Stillbirths in Women With Pregestational Type 1 Diabetes

Author:

Lauenborg Jeannet1,Mathiesen Elisabeth2,Ovesen Per3,Westergaard Jes G.4,Ekbom Pia2,Mølsted-Pedersen Lars5,Damm Peter1

Affiliation:

1. Obstetric Clinic, the Juliane Marie Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark

2. Department of Endocrinology, National University Hospital, Rigshospitalet, Copenhagen, Denmark

3. Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Denmark

4. Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark

5. Department of Obstetrics and Gynecology, Copenhagen University Hospital, Glostrup, Denmark

Abstract

OBJECTIVE—To audit stillbirth cases in women with type 1 diabetes to search for specific characteristics in order to improve antenatal care and treatment RESEARCH DESIGN AND METHODS—Retrospectively identified cases of stillbirths in women with type 1 diabetes during 1990–2000 were analyzed regarding characteristics of the mother, the pregnancy, glycemic control, and the stillborn. The cause of stillbirth was categorized as explainable, likely, or without obvious cause. RESULTS—We found 22 women with 25 stillbirths among 1,361 singleton births by women with type 1 diabetes. In seven stillbirths the cause was categorized as explainable and in six as likely. In 12 cases no obvious cause was found; however, glycemic control was suboptimal in 9 of these cases. A total of 14 women reported daily smoking, and 10 of 19 with low education were unemployed. CONCLUSIONS—Women experiencing stillbirth were characterized by a high incidence of suboptimal glycemic control, diabetic nephropathy, smoking, and low social status.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference29 articles.

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2. Danish National Board of Health Sundhedsstatistikken: The Medical Birth Register: Summary of Birth Statistics 1994 and 1995. No. 6. Copenhagen, Denmark, Munksgaard, 1997

3. Gardosi J, Fagan D: Causes and prevention of antepartum stillbirth. In Textbook of Perinatal Medicine. 1st ed. Kurjac A, Ed. London, New York, The Parthenon Publishing Group, 1998, p. 846–850

4. Kohler L: Infant mortality: the Swedish experience. Annu Rev Public Health 12:177–193, 1991

5. Pedersen J, Pedersen LM, Andersen B: Assessors of fetal perinatal mortality in diabetic pregnancy: analysis of 1,332 pregnancies in the Copenhagen series, 1946–1972. Diabetes 23:302–305, 1974

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