Factors predicting peri- and neonatal outcome in diabetic pregnancy

A population-based birth cohort including 296 consecutive type 1 diabetic b irths in a geographically defined catchment area was used to evaluate facto rs predicting poor perinatal and neonatal outcome. Though perinatal mortali ty has decreased (17.1/1000 births at 28 or more weeks of gestation), the n eonatal morbidity rate still remains high despite improved maternal metabol ic control and developed antepartum surveillance. Poor glycemic control dur ing the first weeks of pregnancy was the most important risk factor (relati ve risk (RR) 2.91; 95% confidence interval (CI) 1.29-6.55) predicting adver se neonatal events such as long (>10 days) stay in the neonatal unit, malfo rmation or perinatal death. The risk was further increased in cases of seve re diabetes (White class F-R; RR 2.75; 95% CI 1.59-4.76) and primiparity(RR 1.64; 95% CI 1.02-2.65). Hy evaluating these risk factors at the first ant enatal visit, a subgroup with a particular need of counselling and intensiv e fete-maternal monitoring can be identified. (C) 2000 Elsevier Science Ire land Ltd. kll rights reserved.