We evaluated the risks of severe perinatal complications according to the type of maternal diabetes from the French birth cohort in 2011.
Method Data were obtained from the PMSI (medical Information system program) and the SNIIRAM (inter-regimens national system of information) of the French health insurance. All the childbirths and the terminations of pregnancy (TOP) after 22 weeks were selected. The mother’s diabetic status was determined by an algorithm based on the consumption of anti diabetics and hospitalisation diagnoses before and during pregnancy. An identifier in the PMSI links mothers and children, thus enabling analyses of associations between the diabetic status and complications in neonates.
Results 806 579 childbirths/TOP > 22 weeks were identified in the PMSI. Mother- child chaining was obtained for 474 614 births. In the case of type 1 and type 2 diabetes, the risk was respectively increased for the following complications (OR adjusted on mother age [95%CI]): perinatal death (2.2 [1.4–3.4] and 3.0 [2.2–4.1]), perinatal asphyxia (3.3 [2.2–5.1] and 2.5 [1.6–3.7]), respiratory distress syndrome (OR adjusted on mother age and gestational age: 2.6 [2.0–3.4] and 1.9 [1.5–2.5]), brachial plexus trauma and/or collarbone fractures in cases of vaginal delivery (8.5 [4.9–14.8] and 2.9 [1.5–5.9]), cardiac malformations (4.4 [3.0–6.5] and 3.2 [2.2–4.7]). In cases of GD, the risk was not increased for these complications compared to the population without diabetes, except for the respiratory distress syndrome (1.2 [1.1–1.3]).
Conclusion The risk of severe perinatal complications remains high in case of pregestational diabetes.