title: Diabetes mellitus and the risk of preterm birth with regard to the risk of spontaneous preterm birth.
abstract: BACKGROUND
  It is internationally agreed that diabetes mellitus (DM) is associated with increased maternal and fetal morbidity and long-term complications. To avoid these complications, it is often necessary to induce birth before term. The impact of DM on spontaneous preterm birth (spontaneous labor, preterm premature rupture of membranes and/or cervical incompetence resulting in delivery before the completion of 37 gestation weeks) is still unexplained. Preterm birth accounts for the most neonatal deaths and infant morbidities, and therefore it still remains one of the biggest challenges in obstetrics.
  
  
  OBJECTIVE
  Our study determined if there is an increasing tendency towards spontaneous preterm birth in mothers with gestational and preexisting DM.
  
  
  METHODS
  In this retrospective cohort study, 187 pregnant women with gestational DM and preexisting DM were compared to a randomized control group consisting of 192 normoglycemic women concerning gestational age and perinatal outcome. Data were collected by the Medical University of Vienna. Multiple pregnancies and women with severe maternal diseases, such as preeclampsia, were excluded.
  
  
  RESULTS
  Women with DM tended significantly more often to preterm births (P = 0.002). A significant difference in the incidence of spontaneous preterm birth was found (P = 0.047).
  
  
  CONCLUSIONS
  DM affects the length of gestation and incidence of spontaneous preterm birth.
authors.affiliation: Department of Obstetrics and Feto-Maternal Medicine, University of Vienna General Hospital, Austria. katharina.koeck@aon.at
authors.forename: Katharina
authors.initials: K
authors.lastname: Köck
authors.forename: Florian
authors.initials: F
authors.lastname: Köck
authors.forename: Katharina
authors.initials: K
authors.lastname: Klein
authors.forename: Dagmar
authors.initials: D
authors.lastname: Bancher-Todesca
authors.forename: Hanns
authors.initials: H
authors.lastname: Helmer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult