Determinants of a good perinatal outcome in 588 pregnancies in women with type 1 diabetes

Lepercq, J.; Ray, Camille Le; Godefroy, Claire; Pelage, L.; Dubois‐Laforgue, Danièle; Timsit, José

doi:10.1016/j.diabet.2018.04.007

Cited by 11 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, a cesarean delivery was necessary in 93.3% of the cases in our study. This rate is much higher than that reported by other international studies Australian [19] (53.6%), Irish [20] (type 1 diabetes: 30%, type 2 diabetes: 36%) or Emirati [21] (39.1%).…”

Section: Discussioncontrasting

confidence: 63%

Pregnancy in Diabetics: Clinicobiological Features and Evolution

Hasni

Belhadj

Ali

et al. 2021

EJMED

View full text Add to dashboard Cite

Background: The association between diabetes and pregnancy is a real public health problem due to the inherent maternal and fetal complications.Aims: To study the clinical and biological features of diabetic pregnancies.Methods: We conducted a retrospective descriptive study including pregnant diabetic women followed at the National Institute of Nutrition of Tunis.Results: We included 100 patients with a mean age of 32.87±5.3 years. In preconception, 63.6% of patients were overweight and had poorly balanced diabetes (HbA1c> 7%). The mean weight gain throughout the pregnancy was 8.62 ± 5.39 kg. Pregnancy was planned in 18% of cases.Significant improvement in HbA1c was observed in the second trimester. The average daily insulin dose increased from 0.68 u/kg/day in the first trimester to 0.87 u/kg/day in the third trimester (p <0.001). Full term delivery occurred in 72% of cases.The majority (93.3%) of our patients gave birth by caesarean section. Macrosomia was observed in 24% of cases. The main neonatal complications were neonatal respiratory distress and hypoglycemia in 26.7% and 20.5% of cases, respectively. Five newborns had deformities.Conclusion: Diabetic pregnancy is associated with an increased risk of maternal and fetal complications. An action on modifiable factors, before conception, could significantly improve its prognosis.

show abstract

Section: Discussioncontrasting

confidence: 63%

Pregnancy in Diabetics: Clinicobiological Features and Evolution

Hasni

Belhadj

Ali

et al. 2021

EJMED

View full text Add to dashboard Cite

show abstract

“…We could not confirm this effect of diabetes duration in the entire cohort. Neither did Lepercq et al in their study on the determinants of a combined good perinatal outcome (including vaginal delivery) in type 1 pregnancies [ 24 ]. Both groups were comparable concerning maternal age and prepregnancy BMI.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that diabetic control influences perinatal outcomes. In the study of Lepercq et al they showed a continuous relationship between HbA1c at delivery and a good perinatal outcome defined as uncomplicated term delivery without macrosomia and lack of neonatal morbidity [ 24 ]. Nevertheless, they did not prove an independent association of HbA1c level with CS [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of a successful vaginal delivery in women with type 1 diabetes: a retrospective analysis of 20 years

Weschenfelder

Herrmann

Schleußner

et al. 2021

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose To evaluate the independent factors associated with the success of a trial of vaginal birth (TVB) in women with type 1 diabetes. Despite all therapeutic efforts and technological innovations, rates of caesarean sections (CS) in pregnant women with type 1 diabetes remain unchanged above 60%. Our aim was to point out influencing factors to improve the quality of antepartum counseling. Methods We performed a retrospective cohort study of 195 pregnancies with type 1 diabetes treated between 2000 and 2019. After exclusions, 118 women with near-term singleton pregnancies intended vaginal birth (TVB). Group differences between CS and successful vaginal delivery were analyzed. Multivariate logistic regression was performed by including clinical and metabolic variables to determine the independent effects on a successful vaginal delivery. Subgroup analysis for nulliparous women. Results Of 118 women with TVB, 67 (56.8%) were delivered vaginally. History of previous vaginal delivery (OR 10.29; CI 2.39; 44.30), HbA1c changes during pregnancy (per % increase; OR 0.59; CI 0.36; 0.96) and gestational weight gain (per kg; OR 0.87; CI 0.80; 0.96) were independent predictors for a successful vaginal delivery. In nulliparous women, the duration of diabetes was independently and negatively associated with vaginal delivery. Conclusion Provided data can help to improve antepartum counseling in type 1 diabetic patients. It seems that women with type 1 diabetes should avoid postponing pregnancy and childbirth.

show abstract

“…In univariate analyses, HbA1c was significantly associated with good perinatal outcomes in the first and second trimesters, as well as in peri-conception. Good perinatal outcomes were defined as the uncomplicated delivery of a normally formed, non-LGA infant after spontaneous labour ≥ 37 weeks or induction of labour ≥ 38 weeks, with no perinatal complications [34].…”

Section: Type 1 Diabetesmentioning

confidence: 99%

Glucose Treatment Targets in Pregnancy - A Review of Evidence and Guidelines

Byford

Forbes

Scott

2023

CDR

View full text Add to dashboard Cite

Background: Maternal diabetes mellitus during pregnancy is associated with an increased risk of pregnancy complications for both the mother and the fetus. One of the most prevalent complications is pathological fetal growth, and particularly infants are born large for gestational age (LGA), which leads to problematic deliveries, including the need for caesarean section, instrumental delivery and further perinatal complications. Glucose monitoring during pregnancy is essential for ensuring appropriate glycaemic control and to reduce these associated risks. The current methods of glucose monitoring include measuring glycosylated haemoglobin (HbA1c), self-monitoring of capillary blood glucose (SMBG), and more recently, continuous glucose monitoring (CGM). Observational studies and randomised controlled trials (RCTs) have assessed the appropriate glycaemic targets for HbA1c, SMBG, and CGM in relation to pregnancy outcomes. Objective: In this review we identify current international guidelines on glycaemic targets and review the supporting evidence. Method: We performed an extensive literature search on glycaemic targets in pregnancies affected by diabetes and we researched international guidelines from recognised societies. Results and Conclusion: The majority of studies used to define the glucose targets associated with the best pregnancy outcomes, across all modalities, were in women with type 1 diabetes. There were limited studies in women with type 2 diabetes and gestational diabetes. We therefore suggest that further research needs to be conducted on glucose targets and clinical outcomes specifically in these populations where CGM technology offers the greatest potential for monitoring glucose and improving pregnancy outcomes.

show abstract

Determinants of a good perinatal outcome in 588 pregnancies in women with type 1 diabetes

Cited by 11 publications

References 34 publications

Pregnancy in Diabetics: Clinicobiological Features and Evolution

Pregnancy in Diabetics: Clinicobiological Features and Evolution

Predictors of a successful vaginal delivery in women with type 1 diabetes: a retrospective analysis of 20 years

Glucose Treatment Targets in Pregnancy - A Review of Evidence and Guidelines

Contact Info

Product

Resources

About