NEW PUBLICATION Perinatal and infant mortality in term and preterm births among women with type 1 diabetes

Lars Christian Stene

This study explores the risk of stillbirth, infant death, preeclampsia and preterm delivery among pregnant women with type 1 diabetes in Norway 1985-2004. The study shows that there is still excess risk of fetal and infant death among women with type 1 diabetes, also in Norway. The risk of preeclampsia and preterm delivery is much higher than in the background population.

More than 1300 deliveries by women registered with type 1 diabetes in the Norwegian Childhood Diabetes Registry were compared to >1 million deliveries in the background population. Data on pregnancy outcome were derived from the Medical Birth Registry of Norway. Results: The odds ratio for stillbirth (≥22 weeks of gestation) was 3.6 [95 % CI: 2.5-5.3], and for perinatal death (stillbirth or death 1st week of life) 2.9 [2.0-4.1]. The odds ratio for infant death (1st year of life) was 1.9 [1.1-3.2]. For preterm birth (< 37 weeks of gestation) and preeclampsia the odds ratios were 4.9 [4.3-5.5] and 6.3 [5.5-7.2], respectively. When preterm and term deliveries were analysed separately, the excess risk of stillbirth and infant death in women with diabetes was confined to term deliveries.

Conclusion: The threefold increased risk of stillbirth and perinatal death in women with type 1 diabetes represents a major challenge. A novel finding of the study was that the increased risk was confined to term births.

The results overall are basically similar to what have been reported from Denmark, Sweden and the Netherlands in recent years and  calls for even better treatment for this patient group.

Eidem I, Vangen S, Hanssen KF, Vollset SE, Henriksen T, Joner G., Stene LC. Perinatal and infant mortality in term and preterm births among women with type 1 diabetes, Diabetologia, 2011, 10.1007/s00125-011-2281-7 [Epub ahead of print]