Tennant, PWG orcid.org/0000-0003-1555-069X, Bilous, RW, Prathapan, S et al. (1 more author) (2015) Risk and Recurrence of Serious Adverse Outcomes in the First and Second Pregnancies of Women With Preexisting Diabetes. Diabetes Care, 38 (4). pp. 610-619. ISSN 0149-5992
Abstract
OBJECTIVE: Women with preexisting (type 1 or type 2) diabetes experience an increased risk of serious adverse pregnancy outcomes. It is not known, however, how these risks change between the first and second pregnancy andwhether there is an increased risk of recurrence. This study describes the absolute risks and recurrence of serious adverse pregnancy outcomes in 220 women with preexisting diabetes. RESEARCH DESIGN AND METHODS: A total of 440 pregnancies occurring in 220 women with preexisting diabetes who delivered successive singleton pregnancies in the North of England during 1996-2008 were identified fromtheNorthern Diabetes in Pregnancy Survey (NorDIP). Predictors of serious adverse outcome were estimated by competing-risks regression. RESULTS: Sixty-seven first pregnancies (30.5%) ended in serious adverse outcome, including 14 (6.4%) with congenital anomalies and 53 (24.1%) additional fetal or infant deaths. Thirty-seven second pregnancies (16.8%) ended in serious adverse outcomedhalf the rate among first pregnancies (P = 0.0004)dincluding 21 (9.5%) with congenital anomalies and 16 (7.3%) additional fetal or infant deaths. Serious adverse outcomes in the second pregnancy occurred twice as frequently in women who experienced a previous adverse outcome than in those who did not (26.9% vs. 12.4%, P = 0.004), but previous adverse outcome was not associated with preparation for the following pregnancy. CONCLUSIONS: Serious adverse outcomes are less common in the second pregnancies of women with preexisting diabetes, although the risk is comparable in those whose first pregnancy ends in adverse outcome. Reducing the risk of recurrence may require more support in the immediate period after an adverse pregnancy outcome.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2015 by the American Diabetes Association. This is an author produced version of a paper published in Diabetes Care. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Sep 2016 14:43 |
Last Modified: | 13 Mar 2019 11:40 |
Published Version: | http://dx.doi.org/10.2337/dc14-1888 |
Status: | Published |
Publisher: | American Diabetes Association |
Identification Number: | 10.2337/dc14-1888 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:97801 |