title: Risk factor profile and pregnancy outcome in women with type 1 and type 2 diabetes mellitus.
abstract: OBJECTIVE
  To assess differences in congenital anomalies, infant mortality, and obstetrical complications as well as risk factors associated with an adverse pregnancy outcome in women with type 1 (T1DM) and type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  This observational study was performed at a university clinic and included a total of 200 singleton pregnancies between January 1995 and December 2006. Outcome measures comprise the prevalence of major congenital malformations, fetal losses, stillbirths, and neonatal deaths as well as the combined end point, adverse pregnancy outcome, and obstetrical complications.
  
  
  RESULTS
  Despite changes in prevailing risk factors, the rate of congenital anomalies and embryonic as well as perinatal death was comparable in type 1 diabetic women over time as well as between women with T1DM and T2DM. Outcome measures and risk factor profile were similar in women with preconception and newly diagnosed T2DM. Glycemic control and increased body mass index (BMI) during the first trimester were the strongest predictors of an adverse pregnancy outcome. Hemoglobin A1c (HbA1c) was higher in T1DM than in T2DM but similar in women with T1DM over time. BMI was highest in women with T2DM, followed by T1DM women of the most recent time period.
  
  
  CONCLUSIONS
  In addition to HbA1c, other risk factors, especially high BMI, strongly influence pregnancy outcome. The higher prevalence of these risk factors in T2DM might compensate for the better glycemic control, resulting in a pregnancy outcome comparable to that of T1DM. Pregnancy outcome in T1DM remained unchanged over time, possibly because of the missing amelioration of HbA1c levels and the increasing BMI.
authors.affiliation: Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Ammon
authors.initials: A
authors.lastname: Handisurya
authors.forename: Dagmar
authors.initials: D
authors.lastname: Bancher-Todesca
authors.forename: Edith
authors.initials: E
authors.lastname: Schober
authors.forename: Katharina
authors.initials: K
authors.lastname: Klein
authors.forename: Karin
authors.initials: K
authors.lastname: Tobler
authors.forename: Barbara
authors.initials: B
authors.lastname: Schneider
authors.forename: Arnold
authors.initials: A
authors.lastname: Pollak
authors.forename: Peter
authors.initials: P
authors.lastname: Husslein
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D015897:Comorbidity; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D011295:Prenatal Care / Q000379:methods; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016387:Women's Health; D055815:Young Adult