title: Development and evaluation of a standardized registry for diabetes in pregnancy using data from the Northern, North West and East Anglia regional audits.
abstract: OBJECTIVE
  To develop and evaluate a standardized data set for measuring pregnancy outcomes in women with Type 1 and Type 2 diabetes and to compare recent outcomes with those of the 2002-2003 Confidential Enquiry into Maternal and Child Health.
  
  
  METHODS
  Existing regional, national and international data sets were compared for content, consistency and validity to develop a standardized data set for diabetes in pregnancy of 46 key clinical items. The data set was tested retrospectively using data from 2007-2008 pregnancies included in three regional audits (Northern, North West and East Anglia). Obstetric and neonatal outcomes of pregnancies resulting in a stillbirth or live birth were compared with those from the same regions during 2002-2003.
  
  
  RESULTS
  Details of 1381 pregnancies, 812 (58.9%) in women with Type 1 diabetes and 556 (40.3%) in women with Type 2 diabetes, were available to test the proposed standardized data set. Of the 46 data items proposed, only 16 (34.8%), predominantly the delivery and neonatal items, achieved ≥ 85% completeness. Ethnic group data were available for 746 (54.0%) pregnancies and BMI for 627 (46.5%) pregnancies. Glycaemic control data were most complete-available for 1217 pregnancies (88.1%), during the first trimester. Only 239 women (19.9%) had adequate pregnancy preparation, defined as pre-conception folic acid and first trimester HbA(1c) ≤ 7% (≤ 53 mmol/mol). Serious adverse outcome rates (major malformation and perinatal mortality) were 55/1000 and had not improved since 2002-2003.
  
  
  CONCLUSIONS
  A standardized data set for diabetes in pregnancy may improve consistency of data collection and allow for more meaningful evaluation of pregnancy outcomes in women with pregestational diabetes.
authors.affiliation: Health Intelligence, Yorkshire and Humber Public Health Observatory, University of York, York, UK.
authors.forename: N
authors.initials: N
authors.lastname: Holman
authors.forename: N
authors.initials: N
authors.lastname: Lewis-Barned
authors.forename: R
authors.initials: R
authors.lastname: Bell
authors.forename: H
authors.initials: H
authors.lastname: Stephens
authors.forename: J
authors.initials: J
authors.lastname: Modder
authors.forename: J
authors.initials: J
authors.lastname: Gardosi
authors.forename: A
authors.initials: A
authors.lastname: Dornhorst
authors.forename: R
authors.initials: R
authors.lastname: Hillson
authors.forename: B
authors.initials: B
authors.lastname: Young
authors.forename: H R
authors.initials: HR
authors.lastname: Murphy
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D036861:Delivery, Obstetric; D003922:Diabetes Mellitus, Type 1 / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008485:Medical Audit; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D011295:Prenatal Care / Q000379:methods; D015995:Prevalence
chemical_list: D001786:Blood Glucose