RELATIONSHIP BETWEEN HEMOGLOBIN-A1C IN EARLY TYPE-1 (INSULIN-DEPENDENT) DIABETIC PREGNANCY AND THE OCCURRENCE OF SPONTANEOUS-ABORTION AND FETAL MALFORMATION IN SWEDEN

被引:160
作者
HANSON, U
PERSSON, B
THUNELL, S
机构
[1] KAROLINSKA INST,ST GORANS CHILDRENS HOSP,DEPT PAEDIAT,BOX 12500,S-11281 STOCKHOLM,SWEDEN
[2] ST GORANS CHILDRENS HOSP,DEPT CLIN CHEM,S-11281 STOCKHOLM,SWEDEN
[3] KAROLINSKA HOSP,DEPT CHIM PHYS ORGAN,S-10401 STOCKHOLM 60,SWEDEN
关键词
C-peptide; fetal malformation; HbA[!sub]1C[!/sub; pregnancy; spontaneous abortion; Type 1 (insulin-dependent) diabetes mellitus;
D O I
10.1007/BF00401047
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This prospective nationwide study examined the relationship between diabetic control in early pregnancy as assessed by HbA1C and the incidence of spontaneous abortion and fetal malformation. HbA1C and plasma C-peptide were determined in 532 women with Type 1 (insulin-dependent) diabetes mellitus, corresponding to approximately 80% of all the diabetic pregnancies in the country during the study period 1982-1985, and 222 non-diabetic control women. Median gestational week for sampling was 9.0 in the Type 1 diabetic and 10.0 in the control group. The median value of HbA1C was 7.7% in the diabetic and 5.3% in the control group (p<0.001). The rates of spontaneous abortion, 7.7% vs 7.2%, and malformation, 4.3% (major 2.0%) and 2.4% (major 1.0%), were not significantly different between the diabetic and control group, respectively. These rates of malformation were not significantly different from the national figures of 4.55% (major 1.75%). Much elevated HbA1C, i.e., > 10.1% equal to 8 SD above the normal mean control value, was significantly associated with the occurrence of spontaneous abortion (p<0.001) and malformation (p<0.01). Discriminant analysis revealed that after correction had been made for the significant value of HbA1C to predict the occurrence of spontaneous abortion and malformation, no further predictive power was displayed by measurable plasma C-peptide, maternal age or duration of diabetes or presence of diabetic microangiopathy. We conclude that poor metabolic control in early pregnancy contributes to an increased risk of both spontaneous abortion and fetal malformation. © 1990 Springer-Verlag.
引用
收藏
页码:100 / 104
页数:5
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