Pregnancy outcomes in diabetes subtypes: how do they compare? A province-based study of Ontario, 2005-2006.
OBJECTIVE
To ascertain differences in pregnancy outcomes between women with diabetes subtypes (type 1 [DM1], type 2 [DM2], women with gestational [GDM])] and non-diabetic women within a large Canadian population.


METHODS
We performed a retrospective multi-cohort analysis of all obstetrical deliveries that occurred in the province of Ontario between April 1, 2005, and March 31, 2006. Data were extracted from the Ontario Niday Perinatal Database.


RESULTS
Increased rates of major negative maternal and perinatal outcomes (i.e. preterm delivery, Caesarean section, pregnancy-induced hypertension/preeclampsia) occurred in women with DM1. Both DM1 and GDM subtypes were associated with the greatest risk of macrosomia, shoulder dystocia, and congenital anomalies. DM2 did not demonstrate an association with an increased risk of congenital malformations and stillbirth.


CONCLUSIONS
Diabetes in pregnancy, irrespective of subtype, predisposes women to poorer outcomes than those of the general obstetric population. However, this large population analysis is consistent with previous studies in showing that the adversity remains greatest for women with type 1 diabetes.
Peticca
Patricia
P
Department of Medicine, The Ottawa Hospital, Ottawa ON.
Keely
Erin J
EJ
Department of Medicine, The Ottawa Hospital, Ottawa ON; Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa ON.
Walker
Mark C
MC
Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON.
Yang
Qiuying
Q
Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON.
Bottomley
Jim
J
The Ontario Perinatal Surveillance System, Ottawa ON.
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D012189:Retrospective Studies