POOR GLYCEMIC CONTROL AND ANTEPARTUM OBSTETRIC COMPLICATIONS IN WOMENWITH INSULIN-DEPENDENT DIABETES

OBJECTIVE: The purpose of this study was to test the hypotheses that t he rate of complications of pregnancy in women with insulin-dependent diabetes is higher than in nondiabetic women and is associated with po or glycemic control and microvascular disease. METHOD: Women who enrol led in a multidisciplinary program of diabetes in pregnancy prior to 2 0 weeks' gestation were included in the study and matched 1:2 by age, race and parity to a control group of nondiabetic women. Complications of pregnancy were retrospectively analyzed and compared between group s. The association of complications with glycemic control and microvas cular disease was analyzed within the diabetic group. RESULT: Women wi th diabetes had significantly higher rates of pregnancy-induced hypert ension (PIH), polyhydramnios, pyelonephritis, preterm delivery and mec onium-stained amniotic fluid. Poor glycemic control, particularly duri ng the first and second trimesters of pregnancy, was associated with a ll complications, except pyelonephritis. Microvascular disease was ass ociated with PIH and preterm delivery prior to 34 weeks. CONCLUSION: W omen with insulin-dependent diabetes are at high risk for complication s of pregnancy. Glycemic control during the first and second trimester s may affect events later in pregnancy.