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Perinatal mortality in diabetic pregnancy.
N Vitoratos1, N Vrachnis, G Valsamakis
1Second Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens Medical School, Athens, Greece. nikolasvitoratos@yahoo.gr
Annals of the New York Academy of Sciences
|September 16, 2010
Summary
Diabetic pregnancies have higher perinatal mortality rates (PMR). Optimizing glycemic control before and during pregnancy significantly reduces congenital abnormalities, complications, and PMR in diabetic women.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Perinatal mortality rate (PMR) is a key indicator of perinatal health.
- PMR in diabetic pregnancies is elevated globally compared to the general population.
- Increasing pregestational diabetes prevalence correlates with risks like congenital malformations, macrosomia, preeclampsia, and preterm delivery.
Purpose of the Study:
- To highlight the significance of PMR in diabetic pregnancies.
- To discuss factors contributing to elevated PMR in diabetes.
- To emphasize the importance of preconception and antenatal glycemic control.
Main Methods:
- Review of existing literature on perinatal mortality in diabetic pregnancies.
- Analysis of factors contributing to PMR in pregestational and gestational diabetes.
- Assessment of the impact of glycemic control on pregnancy outcomes.
Main Results:
- Congenital abnormalities and preterm labor are primary contributors to higher PMR in pre-existing diabetes.
- Women with gestational diabetes mellitus or impaired glucose tolerance present a varied PMR, particularly if insulin-dependent.
- Optimized glycemic control periconceptionally and throughout pregnancy is associated with reduced adverse outcomes.
Conclusions:
- Pregnancy planning and strict glycemic management are crucial for women with diabetes.
- Effective glycemic control can mitigate risks of congenital abnormalities, obstetric complications, and perinatal mortality.
- Improved perinatal health indicators in diabetic pregnancies necessitate proactive management strategies.
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