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Poster session II Clinical obstetrics, diabetes, labor, medical-surgical-disease, physiology/endocrinology, prematurity: Abstracts 237 - 386| Volume 208, ISSUE 1, SUPPLEMENT , S121, January 01, 2013

266: Perinatal outcomes in patients with type 1 versus type 2 diabetes: a retrospective cohort study

      Objective

      To compare maternal and perinatal outcomes among patients with Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM).

      Study Design

      This was a retrospective cohort study of pregnant women with preexisting T1DM or T2DM delivering in California in 2006. Primary predictors included T1DM versus T2DM. Chi-squared tests, Fisher's exact tests, and multivariate regression analyses were performed to investigate the relationship between the primary predictors and a wide range of maternal and neonatal complications.

      Results

      The study included 2787 women, of which 563 (20.2%) were complicated by T1DM and 2,224 (79.8%) by T2DM. In comparison to patients with T1DM, patients with T2DM had lower rates of preterm delivery (18.6% vs 28.8%, p<0.001), fetal anomalies (9.0% vs 12.4%, p=.014), and neonatal respiratory distress syndrome (2.2% vs 6.4%, p<0.001). These lower rates of respiratory distress syndrome (RDS) were persistently lower in T2DM when examining term patients alone (0.39% vs 2.0%, p=0.002). When controlling for potential confounders, having T2DM versus T1DM was associated with lower risks of RDS (AOR 0.47, 95% CI 0.28-0.81) and preterm delivery (AOR 0.58, 95% CI 0.46-0.72).

      Conclusion

      Women with T1DM have higher rates of fetal anomalies, preterm delivery, and neonatal RDS than patients with T2DM. The mechanism of increased RDS in T1DM requires further study.
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      Perinatal outcomes in type 1 vs type 2 diabetes mellitus