The outcome of pregnancy in diabetic women: I. Fetal wastage, mortality, and morbidity in the offspring of diabetic and normal control mothers

Abstract

The outcome of 235 pregnancies in diabetic and prediabetic women was investigated and the results obtained were compared with the corresponding data in the 249 pregnancies of matched normal controls. The percentage of abortions and previable deaths in the diabetic sample was 29.9, in the prediabetic sample 20.5, and in the normal controls 12.4. Stillbirths occurred with the following frequency: 11.5 per cent in the sample of diabetic mothers, 5.1 per cent in the prediabetics, and 1.2 per cent in the normal controls. The neonatal deaths amounted to 8.3 per cent of all pregnancies in the diabetic women, 1.3 per cent in the prediabetics, and 3.6 per cent in the sample of normal controls. These values demonstrate clearly that the fetal wastage in the diabetic women was significantly greater than in the normal controls. The fetal loss during the prediabetic stage was about midway between that in diabetic and normal control mothers. The results obtained generally confirm the findings of other investigators. The main purpose of our study was to test the hypothesis that the morbidity dating since birth in the offspring of diabetic mothers is also increased as compared with the sample of normal controls. There were 6 abnormal surviving offspring in the sample of 157 diabetic pregnancies, which amounts to a total of 3.8 per cent (or 7.6 per cent of the surviving children). In the normal control sample of 249 pregnancies there was only 1 abnormal surviving offspring, which constitutes the incidence of 0.4 per cent. The difference in percentages in these two groups was significant at P less than 0.01, indicating that our hypothesis is very likely correct. The abnormalities in these children include mental deficiency, congenital malformations, birth injury, and epilepsy. The outcome of 235 pregnancies in diabetic and prediabetic women was investigated and the results obtained were compared with the corresponding data in the 249 pregnancies of matched normal controls. The percentage of abortions and previable deaths in the diabetic sample was 29.9, in the prediabetic sample 20.5, and in the normal controls 12.4. Stillbirths occurred with the following frequency: 11.5 per cent in the sample of diabetic mothers, 5.1 per cent in the prediabetics, and 1.2 per cent in the normal controls. The neonatal deaths amounted to 8.3 per cent of all pregnancies in the diabetic women, 1.3 per cent in the prediabetics, and 3.6 per cent in the sample of normal controls. These values demonstrate clearly that the fetal wastage in the diabetic women was significantly greater than in the normal controls. The fetal loss during the prediabetic stage was about midway between that in diabetic and normal control mothers. The results obtained generally confirm the findings of other investigators. The main purpose of our study was to test the hypothesis that the morbidity dating since birth in the offspring of diabetic mothers is also increased as compared with the sample of normal controls. There were 6 abnormal surviving offspring in the sample of 157 diabetic pregnancies, which amounts to a total of 3.8 per cent (or 7.6 per cent of the surviving children). In the normal control sample of 249 pregnancies there was only 1 abnormal surviving offspring, which constitutes the incidence of 0.4 per cent. The difference in percentages in these two groups was significant at P less than 0.01, indicating that our hypothesis is very likely correct. The abnormalities in these children include mental deficiency, congenital malformations, birth injury, and epilepsy.