title: Comparison of placental findings in type 1 and type 2 diabetic pregnancies.
abstract: BACKGROUND
  The aim of this study is to compare placental pathology and related clinical parameters between gravidas with type 1 and type 2 pregestational diabetes.
  
  
  METHODS
  This is a retrospective cohort study of women with singleton gestations and pregestational diabetes who delivered at Women and Infants Hospital from 2003 to 2011. Pathology reports, maternal and neonatal outcomes were extracted and compared between the two groups.
  
  
  RESULTS
  In our cohort, 293 pregnancies were studied, including 117 with type 1 diabetes and 176 with type 2 diabetes. Women with type 1 diabetes had worse glycemic control during pregnancy, as characterized by higher HbA1c values and average fasting and postprandial blood sugars. More infants from the type 1 group were admitted to Neonatal ICU. Pregestational diabetes led to small for gestational age (SGA) placentas in nearly 20% pregnancies and large for gestational age (LGA) placentas in 30% of cases. Both groups shared similar incidences of preeclampsia and significant placental pathology related to uteroplacental (maternal) and fetal circulatory disorders; however, maternal decidual vasculopathy and placentas with insufficiency (fetal-to-placental weight ratio < 10th %tile) were more commonly found in placentas from women with type 2 diabetes.
  
  
  CONCLUSIONS
  Both types of pregestational diabetes have significant impact on placental growth and development. The comparison between the two groups suggests different pathogenetic mechanisms and may be helpful for better management of diabetic pregnancy.
authors.affiliation: Washington Hospital Center, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, 106 Irving Street Suite 108, Washington, DC 20010, USA; Women and Infants Hospital of Rhode Island, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, 101 Dudley Street 3rd Floor, Providence, RI 02905, USA.
authors.forename: R
authors.initials: R
authors.lastname: Starikov
authors.affiliation: Women and Infants Hospital of Rhode Island, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, 101 Dudley Street 3rd Floor, Providence, RI 02905, USA.
authors.forename: K
authors.initials: K
authors.lastname: Inman
authors.affiliation: Women and Infants Hospital of Rhode Island, Department of Medicine, 101 Dudley Street, Providence, RI 02905, USA; Warren Alpert Medical School of Brown University, Providence, RI 02906, USA.
authors.forename: K
authors.initials: K
authors.lastname: Chen
authors.affiliation: Women and Infants Hospital of Rhode Island, Department of Research, 101 Dudley Street, Providence, RI 02905, USA.
authors.forename: V
authors.initials: V
authors.lastname: Lopes
authors.affiliation: Washington Hospital Center, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, 106 Irving Street Suite 108, Washington, DC 20010, USA.
authors.forename: E
authors.initials: E
authors.lastname: Coviello
authors.affiliation: Women and Infants Hospital of Rhode Island, Department of Pathology & Laboratory Medicine, Division of Perinatal Pathology, 101 Dudley Street, Providence, RI 02905, USA; Warren Alpert Medical School of Brown University, Providence, RI 02906, USA.
authors.forename: H
authors.initials: H
authors.lastname: Pinar
authors.affiliation: Women and Infants Hospital of Rhode Island, Department of Pathology & Laboratory Medicine, Division of Perinatal Pathology, 101 Dudley Street, Providence, RI 02905, USA; Warren Alpert Medical School of Brown University, Providence, RI 02906, USA. Electronic address: Mai_he@brown.edu.
authors.forename: M
authors.initials: M
authors.lastname: He
mesh_terms: D000328:Adult; D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000473:pathology*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000473:pathology*; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Diabetes mellitus; Glycemic control; Outcomes; Pathology; Placenta; Pregestational