French multicentric survey of outcome of pregnancy in women with pregestational diabetes.
OBJECTIVE
To evaluate perinatal outcome in pregnancies in women with type 1 and type 2 diabetes and the influence of preconception care 10 years after the St. Vincent's declaration.


METHODS
A cross-sectional study was conducted in 12 perinatal centers in France in 2000-2001. The main investigated outcomes were perinatal mortality, major congenital malformations, and preterm delivery.


RESULTS
Among 435 single pregnancies, 289 (66.4%) were from women with type 1 and 146 (33.6%) from women with type 2 diabetes. Perinatal mortality rate was 4.4% (0.7% national rate), severe congenital malformations rate was 4.1% (2.2% national rate), and preterm delivery rate was 38.2% (4.7% national rate). Preconception care was provided in 48.5% women with type 1 diabetes and in 24.0% women with type 2 diabetes. Women whose first trimester HbA(1c) was >8% had higher rates of perinatal mortality (9.2 vs. 2.5%; odds ratio 3.9; 95% CI 1.5-9.7; P < 0.005), major congenital malformations (8.3 vs. 2.5%; 3.5; 1.3-8.9; P < 0.01), and preterm delivery (57.6 vs. 24.8%; 1.4; 1.1-1.7; P < 0.005) than those with first trimester HbA(1c) <8%. These results are similar to those reported in France in 1986-1988.


CONCLUSIONS
Pregnancies in women with diabetes are still poorly planned and complicated by higher rates of perinatal mortality and major congenital malformations. Despite knowledge of the importance of intensified glycemic control before pregnancy, reaching the St. Vincent's target needs further implementation in France.
Boulot
Pierre
P
Chabbert-Buffet
Nathalie
N
d'Ercole
Claude
C
Floriot
Michele
M
Fontaine
Pierre
P
Fournier
Alain
A
Gillet
Jean Yves
JY
Gin
Henri
H
Grandperret-Vauthier
Sylvie
S
Geudj
Ann Marie
AM
Guionnet
Brigette
B
Hauguel-de-Mouzon
Sylvie
S
Hieronimus
Sylvie
S
Hoffet
Mederic
M
Jullien
Dominique
D
Lamotte
Marie Françoise
MF
Lejeune
Veronique
V
Lepercq
Jacques
J
Lorenzi
Françoise
F
Mares
Pierre
P
Miton
Alain
A
Penfornis
Alfred
A
Pfister
Brigitte
B
Renard
Eric
E
Rodier
Michel
M
Roth
Philippe
P
Sery
Guy-Alain
GA
Timsit
José
J
Valat
Anne Sylvie
AS
Vambergue
Anne
A
Verier-Mine
Odile
O
D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D015995:Prevalence