Audit on stillbirths in women with pregestational type 1 diabetes

Diabetes Care. 2003 May;26(5):1385-9. doi: 10.2337/diacare.26.5.1385.

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.

MeSH terms

  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / epidemiology*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Infant, Newborn
  • Medical Audit / methods
  • Medical Audit / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies

Substances

  • Glycated Hemoglobin A