[Effect of preconceptional metabolic control in the course of pregnancy in diabetic patients].
BACKGROUND
We analysed the relationship between metabolic control parameters during the preconception stage and pregnancy outcome in diabetic patients.


METHODS
We examined 69 diabetic patients who underwent a preconception control at the Diabetes and Pregnancy Unit between 1992-1998. At the end of the preconception care period, 50 women (72.6%) became pregnant. Eight out of them (16%) had an abortion.


RESULTS
Women who had an abortion did not differ from those who had not an abortion with regard to HbA1c levels at the end of the preconception period, age, duration of diabetes, age at diagnosis,anti-thyroid antibodies or microvascular disease. Among 41 single age stations, fetal macrosomia was observed in 36.6% cases, neonatal hypoglycemia in 19.5% and major congenital malformations in one case. Average level of HbA1c was 7.6 +/- 1.3%and 6.5 +/- 0.7 at the beginning and at the end of the preconception period, respectively (p < 0.001). In the group with macrosomia,average HbA1c at the end of the preconception period was 6.8 +/- 0.66% as opposed to 6.3 +/- 0.7% for the non-macrosomic group (p < 0.05). A linear correlation was seen between HbA1c levels at the end of the preconception period and infant weight (r = 0,432; p = 0,014), birth weight ratio (r = 0,450; p = 0,009), and a morbidity score (r = 0,458;p = 0,007).


CONCLUSIONS
A better metabolic control during the preconception period may contribute to lessen the risk of fetal macrosomia and neonatal morbidity.
Delgado Del Rey
M
M
Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Univesitario La Paz, Madrid.
Herranz
L
L
Martín Vaquero
P
P
Jáñez
M
M
Juan Lozano García
J
J
Darias
R
R
Felipe Pallardo
L
L
D000328:Adult; D005260:Female; D006801:Humans; D016742:Preconception Care; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism* / Q000517:prevention & control*