Pregnancy complicating diabetes

White, Priscilla

doi:10.1016/0002-9343(49)90382-4

Cited by 452 publications

(97 citation statements)

References 1 publication

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“…GDM can be classified according to Whiteʼs classification. Whiteʼs classification A1 comprehends cases of GDM where glucose metabolism is diet controlled only, whereas in Whiteʼs classification A2 glucose levels must be controlled with insulin treatment [6]. Fetal macrosomia can be defined in several ways.…”

Section: Accuracy Of Fetal Weight Estimation In Women With Diet Contrmentioning

confidence: 99%

Accuracy of Fetal Weight Estimation in Women with Diet Controlled Gestational Diabetes

Husslein

Worda

Leipold

et al. 2012

Geburtsh Frauenheilk

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!Purpose: To evaluate whether ultrasound accuracy of estimated fetal weight (EFW) differs in women with diet controlled gestational diabetes mellitus (GDM) compared to nondiabetic pregnant women. Material and Methods: We included 363 patients, 121 patients with diet controlled GDM and 242 patients with a normal oral glucose tolerance test (oGTT). Each case of diet controlled GDM was matched with 2 unaffected controls. All patients were screened/diagnosed for GDM by means of an oGTT. Both groups received ultrasound examination including fetal biometry, using Hadlockʼs Formula, within 7 days to delivery. After birth, gestational age, birthweight and Apgar scores were collected from each newborn. Results: There was a good correlation between EFW and birth weight (coefficient = 0.747, p < 0.001 by Pearson correlation, even after adjustment for glucose status). Regression analyses, including noGDM/GDM, maternal age, maternal body mass index, birth weight and time interval between ultrasound and delivery revealed that only fetal birth weight significantly influences weight difference between ultrasound EFW and actual birth weight at term. Conclusion: Our data suggests that ultrasound accuracy of EFW using Hadlockʼs Formula at term does not differ in women with diet controlled GDM compared to women with normal glucose tolerance.

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Section: Accuracy Of Fetal Weight Estimation In Women With Diet Contrmentioning

confidence: 99%

Accuracy of Fetal Weight Estimation in Women with Diet Controlled Gestational Diabetes

Husslein

Worda

Leipold

et al. 2012

Geburtsh Frauenheilk

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“…However, when calculating perinatal mortality rates, the total number of singleton offspring (n=1,697) was used. The type 1 diabetic patients were categorised based on a slightly modified 1949 White's classification [4], omitting class E (calcified pelvic arteries on x-ray) and including class R [14], as follows: 1) class B: age at onset ≥20 years and diabetes duration <10 years; 2) class C: age at onset 10-19 years or diabetes duration 10-19 years; 3) class D: age at onset <10 years or diabetes duration ≥20 years or background retinopathy; 4) class R: proliferative diabetic retinopathy; and 5) class F: diabetic nephropathy. Only four patients had coronary heart disease (White's class H); two of these patients were categorised as White's class D and two patients as White's class F. One patient had undergone renal transplantation prior to pregnancy (White's class T), but was excluded due to a twin pregnancy.…”

Section: Methodsmentioning

confidence: 99%

“…In 1949, Priscilla White published a classification system for pregnant women with diabetes according to the age at onset, the duration of diabetes and the presence of diabetic vascular complications [4]. Since then, different modifications of the original White's classification have been suggested [5,6].…”

Section: Introductionmentioning

confidence: 99%

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White’s classification and pregnancy outcome in women with type 1 diabetes: a population-based cohort study

et al. 2015

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Aims/hypothesis Our aim was to examine the association of White's classification with obstetric and perinatal risk factors and outcomes in type 1 diabetic patients. Methods Obstetric records of a population-based cohort of 1,094 consecutive type 1 diabetic patients with a singleton childbirth during 1988-2011 were studied. The most recent childbirth of each woman was included. Results The prepregnancy and the first trimester HbA 1c increased from White's class B to F (p for trend <0.001). Systolic and diastolic blood pressure and pre-eclampsia frequencies increased stepwise from class B to F (p for trends <0.001).Vaginal deliveries decreased and Caesarean sections and deliveries before 37 weeks increased from class B to F (p for trends <0.001). Fetal macrosomia (p for trend=0.003) decreased and small-for-gestational age infants (p for trend=0.002) and neonatal intensive care unit admissions (p for trend=0.001) increased from class B to F. In logistic regression analysis, White's classes were associated with pre-eclampsia but, with the exception of class R (proliferative retinopathy) and F (nephropathy), not with other adverse outcomes when adjusted for first trimester HbA 1c ≥7% (≥53 mmol/mol) and blood pressure ≥140/90 mmHg. First trimester HbA 1c ≥7% was associated with pre-eclampsia, preterm delivery, fetal macrosomia and neonatal intensive care unit admission. Conclusions/interpretation White's classification is useful in estimating the risk of pre-eclampsia in early pregnancy independently of suboptimal glycaemic control and hypertension. However, its utility in predicting adverse perinatal outcomes seems limited when information on first trimester HbA 1c , blood pressure and diabetic microvascular complications is available.

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“…However, the numbers are too small for statistical analysis. However, the increased frequency of congenital malformations was not fully recognized until the second half of this century, when a number of authors (White, 1949;Koller, 1953;Reid, 1956;Driscoll, Benirschke and Curtis, 1960) drew attention to this finding in the offspring of diabetic mothers. On the other hand, some authors found no such increased frequency (Given, Douglas and Tolstoi, 1950;Reis, De Costa and Allweiss, 1950;Cardell, 1953;Farquhar, 1959).…”

Section: Control Of Maternal Diabetesmentioning

confidence: 99%

Congenital Malformations in Infants of Diabetic Mothers

1976

QJM: An International Journal of Medicine

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Pregnancy complicating diabetes

Cited by 452 publications

References 1 publication

Accuracy of Fetal Weight Estimation in Women with Diet Controlled Gestational Diabetes

Accuracy of Fetal Weight Estimation in Women with Diet Controlled Gestational Diabetes

White’s classification and pregnancy outcome in women with type 1 diabetes: a population-based cohort study

Congenital Malformations in Infants of Diabetic Mothers

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