Out-patient management does not impair outcome of pregnancy in women with type 1 diabetes

In recent years, out-patient protocols have mainly displaced historical obs tetric management of diabetic pregnancy. The impact of the change from cent ralized in-patient to decentralized out-patient treatment on glycaemic cont rol and its effects on the outcome of newborns in diabetic pregnancies was therefore studied using the population-based data on 296 pregnancies in 224 women with type 1 diabetes over 10 years (1986-1995) in the two northernmo st provinces of Finland. The area comprises one tertiary level and four oth er central hospitals. The change of policy was effected in 1990 and to dete rmine the impact of this change, the study period was divided in two (perio d 1, 1986-1990, n = 135; period 2, 1991-1995, n = 161). At the first antena tal contact (mean 9.9 weeks of gestation) 73% of women had unsatisfactory g lycaemic control, but it improved rapidly with pregnancy and was significan tly better (P < 0.05) in the second study period. The incidence of congenit al malformations was somewhat greater (NS) in period 2 but perinatal mortal ity did not change. Out-patient management does not impair outcome in type 1 diabetic pregnancy. (C) 2000 Elsevier Science Ireland Ltd. All rights res erved.