Spontaneous preterm delivery in the type 1 diabetic pregnancy: the role of glycemic control.
OBJECTIVE
To determine the role of glycemic control in spontaneous preterm delivery in type 1 diabetic women.


METHODS
A secondary analysis of data from women enrolled in the Diabetes in Pregnancy Program prior to 20 weeks was performed. Multiple logistic regression was used to analyze the association between glycohemoglobin A1 in women with spontaneous preterm delivery (n = 53) and women who delivered at term (n = 200). Maternal demographics and obstetric outcomes were also compared between the groups.


RESULTS
Glycohemoglobin A1 levels were higher in the spontaneous preterm delivery group than the term group throughout pregnancy, reaching statistical significance after the first trimester. The last glycohemoglobin A1 prior to delivery was 8.1% in the spontaneous preterm delivery group and 7.4% in the term group (p = 0.002). Using multiple logistic regression, each 1% increase in glycohemoglobin A1 increased the risk of spontaneous preterm delivery by 37%.


CONCLUSIONS
Poor glycemic control is associated with an increased risk of spontaneous preterm delivery, suggesting that strict glycemic control may reduce the rate of preterm delivery in these women.
Kovilam
O
O
University of Cincinnati College of Medicine, Department of Obstetrics and Gynecology, Ohio 45267-0526, USA.
Khoury
J
J
Miodovnik
M
M
Chames
M
M
Spinnoto
J
J
Sibai
B
B
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin