Statistical analysis of perinatal outcomes in pregnancy complicated with diabetes mellitus

To evaluate the outcomes of pregnancies complicated with diabetes mellitus (DM) in the maternal and perinatal center of Tokyo Women's Medical College (TWMC), and compare the results with reports of other countries.

A retrospective study of 482 cases of DM pregnancies were included over a 13-year period in a tertiary care hospital in Tokyo. Information were obtained from medical records of both mothers and babies.

The prevalence of pregnancies complicated with DM was 5.1%. Preeclampsia developed in 124 cases at a rate of 25.8%. Incidence of preterm delivery was 16.6%. Caesarean sections were performed in 36.7% patients. There were significant differences of caesarean section rates between diabetic complication group (retinopathy and nephropathy) and non-complication group (69.5% vs 30.5%, p < 0.0001), and between preterm and term deliveries (60.0% vs 32.1%, p < 0.0001). Maternal backgrounds significantly involved with preterm delivery were DM nephropathy and severe preeclampsia. Babies with heavy for gestational age (HGA) were observed at a rate of 21% in all. There were 3 perinatal deaths (intrauterine fetal deaths, IUFD) with the perinatal mortality rate of 6.1/1,000 births. The incidence of caesarean section and perinatal mortality rate of non-DM pregnancies in our center during the same study period were 16.3% and 7.7/1,000 births respectively.

The perinatal outcome in our study was better compared to other worldwide reports. With accurate perinatal management, perinatal mortality rate of DM pregnancies in the current study was almost same as that of non-DM pregnancies in our center. The main factors to promote adverse perinatal outcomes were presence of DM nephropathy and severe preeclampsia.