Pregnancy outcomes in women with diabetes mellitus – the impact of diabetes type and treatment

Abstract

Introduction: It has been estimated that approximately 16% of pregnancies worldwide are affected by preexisting or gestational insulin-dependent (type 1) or independent (type 2) diabetes mellitus (DM). Diabetes mellitus in pregnancy remains a high-risk condition for both mother and child. This study aimed to investigate pregnancy outcomes regarding DM types.Material and methods: The study included 323 DM patients delivered for 6 years (2012)(2013)(2014)(2015)(2016)(2017). General and obstetric history data and all complications throughout the pregnancy and the early neonatal period were noted. Based on DM type, women were divided into 4 groups: pre-pregnancy/pre-existing DM, insulin-dependent or independent, and gestational diabetes mellitus with or without insulin therapy.Results: The majority of women had pre-existing insulin-independent DM (type II 62%). Some types of pregnancy/maternal complications were registered in almost 85% of examined pregnancies. However, all babies were live born and mostly with good outcome (36.85% with early neonatal complications). Diabetes mellitus type could not predict the occurrence of neonatal complications (p = 0.342). Pre-existing insulin-dependent DM increased the risk for pregnancy complications (p = 0.031; OR = 1.656).Conclusions: Diabetes mellitus type has a limited impact on pregnancy outcomes and the occurrence of maternal and neonatal complications. With adequate therapy the pregnancy outcome can be good regardless of DM type.

Could chorionic bump represent an early ultrasound marker of Klinefelter syndrome? A case report of our experience

“…more than 35 years old) could be considered a risk factor for congenital malformations [10] and having pre-existing insulin-independent Diabetes Mellitus has been shown to correlate with more fetal anomalies seen on ultrasound. [11] In conclusion, this is the first case of chorionic bump associated to Klinefelter syndrome. Even if this finding might be accidental and its meaning is still controversial, it might be consistent with the hypothesis of an association between chorionic bump and aneuploidies that has already been advanced by other authors.…”

Bilobed placenta and management choices: liture review and two cases studies

“…Prenatal care is paramount for early diagnosis and management of several obstetric conditions [42][43][44]. An antenatal diagnosis of bilobed placenta may minimize pre-and postpartum complications.…”

The influence of advanced age and obesity on pregnancy course and outcome in patients with diabetes mellitus

“…Diabetes mellitus is considered to be one of the most important independent risk factors for most adverse perinatal outcomes, including major foetal malformations and stillbirth [ 7 , 8 , 13 ]. Obese women are more insulin resistant than normal weight women.…”