title: Out-patient management does not impair outcome of pregnancy in women with type 1 diabetes.
abstract: In recent years, out-patient protocols have mainly displaced historical obstetric management of diabetic pregnancy. The impact of the change from centralized in-patient to decentralized out-patient treatment on glycaemic control and its effects on the outcome of newborns in diabetic pregnancies was therefore studied using the population-based data on 296 pregnancies in 224 women with type 1 diabetes over 10 years (1986-1995) in the two northernmost provinces of Finland. The area comprises one tertiary level and four other central hospitals. The change of policy was effected in 1990 and to determine the impact of this change, the study period was divided in two (period 1, 1986-1990, n = 135; period 2, 1991-1995, n = 161). At the first antenatal contact (mean 9.9 weeks of gestation) 73% of women had unsatisfactory glycaemic control, but it improved rapidly with pregnancy and was significantly better (P < 0.05) in the second study period. The incidence of congenital malformations was somewhat greater (NS) in period 2 but perinatal mortality did not change. Out-patient management does not impair outcome in type 1 diabetic pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Oulu, Finland. marja.vaarasmaki@oulu.fi
authors.forename: M
authors.initials: M
authors.lastname: Vääräsmäki
authors.forename: A L
authors.initials: AL
authors.lastname: Hartikainen
authors.forename: M
authors.initials: M
authors.lastname: Anttila
authors.forename: H
authors.initials: H
authors.lastname: Pirttiaho
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D000013:Congenital Abnormalities / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010045:Outpatients; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000628:therapy*; D011295:Prenatal Care
chemical_list: D001786:Blood Glucose