Poor pregnancy outcome in women with type 2 diabetes

OBJECTIVE- To evaluate the perinatal Outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996-2001. RESEARCH DESIGN AND METHODS- Medical records of 61 consecutive singleton pregnancies in women with type 2 diabetes from 1996 to 2001 were studied. Pregnancy outcome was compared with that of pregnant women with type I diabetes during 1996-2000, the background population, and pregnant women with type 2 diabetes during 1980-1992 from the same department. RESULTS- The perinatal mortality in pregnancies complicated by type 2 diabetes (4/61. 6.6%) was increased Four- and ninefold, respectively, and the rate of major congenital malformations (4/60, 6.7%) was more than doubled, although not statistically significant compared with type I diabetic pregnancies and the background population. The glycemic control was similar or better in women with type 2 diabetes compared,with women with type I diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational were diabetes from 1996 to 2001 showed that high HbA(1c) at admission and type 2 diabetes independently associated with a serious adverse fetal Outcome (perinatal mortality and/or major congenital malformations). The perinatal mortality and the rate of major congenital malformations in type 2 diabetic pregnancies have increased during the last decade. CONCLUSIONS - The perinatal outcome of pregnancies in women with type 2 diabetes during 1996-2001. is poor. It is worse than the outcome of pregnancies in women with type 1 0 diabetes and the background population in the same period, as well as in women with type 2 diabetes studied during 1982-1990. Diabetes Care 28:323-328. 2005.