Clinical outcomes of pregnancy in women with type 1 diabetes(1).
OBJECTIVE
To evaluate predictors of neonatal hypoglycemia and macrosomia in 107 consecutive pregnancies in type 1 diabetic women.


METHODS
We conducted a case record analysis of singleton type 1 diabetic pregnancies between January 1994 and January 1999 following institution of standardized management.


RESULTS
The duration of diabetes in the women was 12.9 +/- 6.8 years, and 44 were primigravidas. The mean HbA1c throughout pregnancy was 7.2 +/- 0.8%. There was no relationship between neonatal blood glucose (checked before the second feed) and HbA1c at any point in pregnancy or mean pregnancy HbA1c (R = 0.20, P >.1). However, there was a negative correlation between neonatal blood glucose and maternal blood glucose during labor (R = -0.33, P <.001). When maternal blood glucose during labor was greater than 8 mM (144 mg/dL), neonatal blood glucose was usually less than 2.5 mM (mean 1.7 +/- 0.4 mM or 31 mg/dL). There was no relationship between mean HbA1c and birth weight (R = 0.02, P >.1) or between maximum insulin dose and birth weight (R = 0.09, P >.1). Fetal abdominal circumference measured by ultrasound at 34 weeks correlated strongly with birth weight (R = 0.72, P <.001).


CONCLUSIONS
Neonatal hypoglycemia correlates with maternal hyperglycemia in labor, not with HbA1c during pregnancy. Macrosomia does not correlate with HbA1c during pregnancy.
Taylor
Roy
R
Department of Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. roy.taylor@ncl.ac.uk
Lee
Choy
C
Kyne-Grzebalski
D
D
Marshall
S M
SM
Davison
J M
JM
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005320:Fetal Macrosomia / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology*; D007231:Infant, Newborn; D007328:Insulin; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D016216:Ultrasonography, Prenatal
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin