Prospective population based survey of outcome of pregnancy in diabetic women: results of the Northern Diabetic Pregnancy Audit, 1994

摘要

Objective: To determine whether the St Vincent declaration (1989) target of diabetic pregnancy outcome approximating non-diabetic pregnancy outcome is near to being achieved. Design: Prospective collection of population based information on pregnancies in women with diabetes from all participating hospitals. Setting: District general and teaching hospitals of the former Northern region. Subjects: 111 diabetic women booking with pregnancy during 1 January to 31 December 1994. Main outcome measures: Diabetic control, perinatal mortality rate, fetal abnormality rate. Results: The perinatal mortality rate was 48/1000 for diabetic pregnancies compared with 8.9/1000 for the background population (odds ratio 5.38; 95% confidence interval 2.27 to 12.70) and the neonatal mortality rate was 59/1000 compared with 3.9/1000 (15.0; 6.77 to 33.10). Two late neonatal deaths were due to congenital heart defects. Six per cent of all fetal losses (6/109 cases) were due to major malformations. The congenital malformation rate was 83/1000 compared with 21.3/1000 (3.76; 2.00 to 7.06) in the background population. Conclusion: Diabetic pregnancy remains a high risk state with perinatal mortality and fetal malformation rates much higher than in the background population.