Type 2 diabetes and pregnancy.
Type 2 diabetes is a growing concern, with the number of new cases increasing and occurring at a younger age due to obesity. Consequently the number of cases arising in women of child-bearing age is increasing, and the condition will be encountered more frequently in the antenatal clinic. Type 2 diabetes is often perceived as a benign form of diabetes, but this is not the case when one examines pregnancy outcomes. Rates of perinatal mortality (25/1000) and congenital malformation (99/1000) are significantly greater than those in background populations and at least as poor as those in type 1 diabetes. The rates of hypertension, pre-eclampsia and postpartum haemorrhage are greater than the general maternity population, as is the rate of operative delivery. To improve outcomes we need to dispel the myth that type 2 diabetes is a benign condition. Educational programmes, population screening, and strategies to help vulnerable groups access the services available will increase our ability to identify and counsel women with type 2 diabetes early enough to make a difference.
Dunne
Fidelma
F
Department of Medicine, Clinical Science Institute, University College Hospital, Galway, Ireland. fidelma.dunne@nuigalway.ie
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000013:Congenital Abnormalities / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011295:Prenatal Care; D012307:Risk Factors