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984 Population-Based Study to Evaluate the Neonatal Morbidity and Mortality in Maternal Diabetes
  1. A Lange1,
  2. R Spoo2,
  3. R Thyrian3,
  4. W Hoffmann3,
  5. H Lode4,
  6. M Heckmann2
  1. 1Neonatology and Intensiv Care, University of Greifswald
  2. 2Neonatology and Pediatric Intensive Care, University Children’s Hospital
  3. 3Community Medicine, University of Greifswald
  4. 4Haematology and Oncology, University Children’s Hospital, Greifswald, Germany

Abstract

Aim The aim of the study is to determine any connections between maternal diabetes and the pregnancy outcome of mothers and newborns.

Methods From 03/2003 to 11/2008 in local and university hospitals in Northeast Pomerania, Germany a total of n=4593 mothers and their children were used as a prospective population-based birth cohort. The objective of the survey of newborns in Pomerania (SNiP) is to evaluate the negative pregnancy outcome, morbidity and mortality in diabetes affected pregnant woman. A comparison of glucose-intolerance affected childbearing mothers (n=243) identified by oral glucose tolerance test and non-diabetic mothers (n=4350) were conducted.

Results The prevalence of maternal glucose-intolerance is 5.3%. Comorbidity of maternal diabetes is more prevelant with higher age, greater number of previous pregnancies (parity) and those who are overweight (relative risk 1.97). Macrosomi (OR=2.28) and reduced gestational age are identified as a fetal risk factors. As a maternal risk factor is considered positive vaginal infection (OR=1.97). As a negative outcome a higher rate of Cesarean section, instrumental delivery (OR=1.96) and pathologic final delivery positions (15.3% non-diabetes/9.3% diabetes) can be observed. This all leads to a four times higher odds ratio of post-partus hospitalization (OR=3.70) and mandatory pre-partus therapy (OR=4.78) of the diabetes affected group.

Conclusions Newborns of mothers with gestational diabetes demonstrate a fetopathia diabetica with makrosomi and immaturity which leads to higher rate of birth complications and post-partus hospitalisation of almost every second newborn. An increased risk for mothers and their children exists in case of gestational diabetes.

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