[Effect of intensive prenatal and diabetic care on newborn of diabetic mothers--14 years of observation].
Modern management of pregnancies complicated by maternal diabetes mellitus has in view delivery at term an healthy child with correct body mass and in good metabolic condition.


OBJECTIVE
Of our work was estimation of influence of intensive prenatal and diabetical cares on frequency of occurrence of failures and complications at newborns of mothers with pregestational diabetes mellitus delivered in period from 1987 to 2000. Study include 228 of newborns of diabetic mothers of class B-RF according to White, born in our hospital between 25 and 40 weeks of pregnancy. In aim of estimation of percentage of perinatal mortality, congenital malformations, prematurity, hyper- and hypotrophy in examined population of new-born children of mothers with PGDM, material was subdivided into 3 groups in 4 and 5-years intervals: group I (n = 96) 1987-1990, group II (n = 72) 1991-1995, group III (n = 60) 1996-2000r.


RESULTS
Systematical decrease of percentage of perinatal mortality in examined groups from 7.3% to 5.0% was ascertained. There was a significant association between decreasing of number of congenital malformations in investigated new-born population from 12.5% to 5.0% and 2,5-times increasing of percentage of women with PGDM managed by combined team of diabetologist and obstetricians before conception. We observed an essential decreasing of percentage of prematurity in investigated material from 51.6% to 20.0%. Percentage of births of new-born children with macrosomy on space analysed of years was comparable. (13.7%, 14.1% and 15.0%) in spite of increasing of percentage of childbirths at term from to 80%. We did not ascertain increasing of percentage of incidents of IUGR. The percentage of IUGR in investigated groups carried out 5.3%, 5.6% and 5.0% in spite 2-times increasing of percentage of births of children of mothers with diabetes in class R and RF according to the White classification.


CONCLUSIONS
Well controlled diabetes, intensive management of diabetic women by combined team of diabetologists and obstetricians on space 14 of years of activity of our Department due to decreasing of percentage of: perinatal mortality from 7.3% to 5.0%, congenital malformations from 12.5% to 5.0% and premature deliveries from 51.6% to 20.0% in population of new-born children of mothers with PGDM.
Mironiuk
M
M
Katedry i Kliniki Połoznictwa i Ginekologii II wydz. Lek. A.M. w Warszawie.
Kietlińska
Z
Z
Osuch
B
B
Jezierska-Kasprzyk
K
K
Kot
A
A
Reinholz-Jaskólska
M
M
Raźna
I
I
D000328:Adult; D000013:Congenital Abnormalities / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors