Browse by author
Lookup NU author(s): Peter Tennant, Dr Svetlana Glinianaia, Professor Rudy Bilous, Professor Judith RankinORCiD, Dr Ruth Bell
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Aims: Pre-existing diabetes is associated with an increased risk of stillbirth but few studies have excluded the effect of congenital anomalies. This study used data from a long-standing population-based survey of women with pre-existing diabetes to investigate the risks of fetal and infant death and quantify the contribution of glycaemic control. Methods: All normally-formed singleton offspring occurring in women with pre-existing diabetes (n=1206 with type 1 diabetes and n=342 with type 2 diabetes) in the North of England during 1996-2008 were identified from the Northern Diabetes in Pregnancy Survey. Relative risks (RRs) of fetal death (≥20 weeks' gestation) and infant death were estimated by comparison with population data from the Northern Perinatal Morbidity and Mortality Survey. Predictors of fetal and infant death in women with pre-existing diabetes were examined by logistic regression. Results: The prevalence of fetal death in women with diabetes was over four times greater than among those without [RR=4.56 (95% confidence interval, CI: 3.42, 6.07) p<0.0001], while for infant death it was nearly doubled [RR=1.86 (95% CI: 1.00, 3.46) p=0.046]. There was no difference in the prevalence of fetal death (p=0.51) or infant death (p=0.70) between women with type 1 diabetes and women with type 2 diabetes. There was no evidence that the RR of fetal and infant death had changed over time (p=0.95). Increasing peri-conception HbA1c above 49mmol/mol (6.6%) [adjusted odds ratio, aOR=1.02 (95% CI: 1.00, 1.04) p=0.01], pre-pregnancy retinopathy [aOR=2.05 (95% CI: 1.04, 4.05) p=0.04] and lack of pre-pregnancy folic acid consumption [aOR=2.52 (95% CI: 1.12, 5.65) p=0.03] were all independently associated with increased odds of fetal and infant death. Conclusions: Pre-existing diabetes is associated with a substantially increased risk of fetal and infant death in normally-formed offspring, the effect of which is largely moderated by glycaemic control.
Author(s): Tennant PWG, Glinianaia SV, Bilous RW, Rankin J, Bell R
Publication type: Article
Publication status: Published
Journal: Diabetologia
Year: 2014
Volume: 57
Issue: 2
Pages: 285-294
Print publication date: 01/02/2014
Online publication date: 01/02/2014
Acceptance date: 28/10/2013
ISSN (print): 0012-186X
ISSN (electronic): 1432-0428
Publisher: Springer
URL: http://dx.doi.org/10.1007/s00125-013-3108-5
DOI: 10.1007/s00125-013-3108-5
Notes: epub:29/11/2013
Altmetrics provided by Altmetric
