Diabetes in Pregnancy: A Retrospective Study at St. Francis Hospital Perinatal Center, 1976-1980

Abstract

A retrospective study was done at our Perinatal Center between the years of 1976-1980 to evaluate our experience with diabetic pregnancy as compared to other reporting centers. A small group of 49 patients emerged which was large enough to identify certain trends. As a whole the Center has comparable outcome to other centers but particular areas of concern was the group of primigravidas who experienced more fetal distress (30. 7% had distress) as compared to 2.0 % of controls. Class B diabetics also had more problems. Tighter control is necessary. Antepartum surveillance is improving in this area. Our experience with other factors relating to diabetic pregnancy is discussed. Introduction Diabetes in pregnancy is associated with a greatly-increased perinatal morbidity and mortality. It has been reported that light metabolic control of pregnancy can result in a much better outcome in regard to both of the above parameters.' The sorts of complications that occur can start at the outset of pregnancy with a much increased risk of congenital anomalies (11 % ) being detected especially in younger mothers. 2 This may well relate to poor control being present in gestational or overt diabetes early in pregnancy. The incidence of malformations is generally two to four times that seen in normal pregnancies, accounting for as much as 54 % of all perinatal deaths in diabetic pregnancies.' Insulin and carbohydrate control may be only part of the picture if an early pregnancy is thought of as a sort of tissue culture where many other nutrients may also be permuted by this metabolic disorder.• Possibly the spontaneous abortion rate could be reduced with better control of diabetes early in pregnancy, additionally, good control of diabetes optimizes the pregnancy until such time, if it occurs, that the pregnancy undergoes feta l jeopardy on a uteroplacental basis. 1 5 • The latter can be followed by careful monitoring of placental