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Maternal diabetes and neonatal outcome.
1Department of Medicine, University of Cape Town, Cape Town, South Africa. ecoetzee@uctgsh1.uct.ac.za
Seminars in Neonatology : SN
|August 24, 2000
Summary
New diabetes classifications are discussed. Despite goals, maternal diabetes management falls short of non-diabetic rates, primarily due to insufficient pre-conceptional care for expectant mothers.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Current definitions and classifications of diabetes are evolving.
- Maternal diabetes management faces challenges, particularly in developing nations.
- Existing literature reveals a scarcity of randomized trials on maternal diabetes management.
Purpose of the Study:
- To discuss new definitions and classifications of diabetes.
- To review evidence for managing maternal diabetes.
- To highlight challenges in type 2 diabetes, especially in developing countries.
Main Methods:
- Conducted an electronic literature search focusing on randomized trials for maternal diabetes management.
- Utilized evaluative and retrospective evidence due to limited trial data.
- Highlighted specific issues of type 2 diabetes in the developing world.
Main Results:
- A paucity of randomized trials was identified for maternal diabetes management.
- Proposed management strategies are based on retrospective and evaluative evidence.
- Achieving optimal perinatal and fetal anomaly rates remains a challenge, even in advanced centers.
Conclusions:
- The goals set by the St. Vincent Declaration are theoretically achievable.
- Excellent pre-conceptional care for diabetic mothers is crucial but often lacking.
- Suboptimal pre-conceptional care significantly impacts perinatal and fetal anomaly rates in diabetic pregnancies.