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Audit on stillbirths in women with pregestational type 1 diabetes
Jeannet Lauenborg1, Elisabeth Mathiesen, Per Ovesen
1Obstetric Clinic, the Juliane Marie Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark. lauenborg@dadlnet.dk
Objective:
To audit stillbirth cases in women with type 1 diabetes to search for specific characteristics in order to improve antenatal care and treatment.
Research Design And Methods:
Retrospectively identified cases of stillbirths in women with type 1 diabetes during 1990-2000 were analyzed regarding characteristics of the mother, the pregnancy, glycemic control, and the stillborn. The cause of stillbirth was categorized as explainable, likely, or without obvious cause.
Results:
We found 22 women with 25 stillbirths among 1,361 singleton births by women with type 1 diabetes. In seven stillbirths the cause was categorized as explainable and in six as likely. In 12 cases no obvious cause was found; however, glycemic control was suboptimal in 9 of these cases. A total of 14 women reported daily smoking, and 10 of 19 with low education were unemployed.
Conclusions:
Women experiencing stillbirth were characterized by a high incidence of suboptimal glycemic control, diabetic nephropathy, smoking, and low social status.