PMID- 37501784
OWN - NLM
STAT- MEDLINE
DCOM- 20230731
LR  - 20230731
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 14
DP  - 2023
TI  - Trend of pregnancy outcomes in type 1 diabetes compared to control women: a 
      register-based analysis in 1996-2018.
PG  - 1232618
LID - 10.3389/fendo.2023.1232618 [doi]
LID - 1232618
AB  - INTRODUCTION: In 1989, the St Vincent declaration aimed to approximate pregnancy 
      outcomes of diabetes to that of healthy pregnancies. We aimed to compare 
      frequency and trends of outcomes of pregnancies affected by type 1 diabetes and 
      controls in 1996-2018. METHODS: We used anonymized records of a mandatory 
      nation-wide registry of all deliveries between gestational weeks 24 and 42 in 
      Hungary. We included all singleton births (4,091 type 1 diabetes, 1,879,183 
      controls) between 1996 and 2018. We compared frequency and trends of pregnancy 
      outcomes between type 1 diabetes and control pregnancies using hierarchical 
      Poisson regression. RESULTS: The frequency of stillbirth, perinatal mortality, 
      large for gestational age, caesarean section, admission to neonatal intensive 
      care unit (NICU), and low Appearance, Pulse, Grimace, Activity, and Respiration 
      (APGAR) score was 2-4 times higher in type 1 diabetes compared to controls, while 
      the risk of congenital malformations was increased by 51% and SGA was decreased 
      by 42% (all p<0.05). These observations remained significant after adjustment for 
      confounders except for low APGAR scores. We found decreasing rate ratios 
      comparing cases and controls over time for caesarean sections, low APGAR scores 
      (p<0.05), and for NICU admissions (p=0.052) in adjusted models. The difference 
      between cases and controls became non-significant after 2009. No linear trends 
      were observed for the other outcomes. CONCLUSIONS: Although we found that the 
      rates of SGA, NICU care, and low APGAR score improved in pregnancies complicated 
      by type 1 diabetes, the target of the St Vincent Declaration was only achieved 
      for the occurrence of low APGAR scores.
CI  - Copyright (c) 2023 Fazekas-Pongor, Svebis, Major, Partos, Dosa, Meszaros, Horvath, 
      Domjan, Zsirai and Tabak.
FAU - Fazekas-Pongor, Vince
AU  - Fazekas-Pongor V
AD  - Department of Public Health, Faculty of Medicine, Semmelweis University, 
      Budapest, Hungary.
FAU - Svebis, Mark M
AU  - Svebis MM
AD  - Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis 
      University, Budapest, Hungary.
FAU - Major, David
AU  - Major D
AD  - Department of Public Health, Faculty of Medicine, Semmelweis University, 
      Budapest, Hungary.
FAU - Partos, Katalin
AU  - Partos K
AD  - Department of Public Health, Faculty of Medicine, Semmelweis University, 
      Budapest, Hungary.
FAU - Dosa, Norbert
AU  - Dosa N
AD  - Department of Public Health, Faculty of Medicine, Semmelweis University, 
      Budapest, Hungary.
FAU - Meszaros, Agota
AU  - Meszaros A
AD  - Department of Public Health, Faculty of Medicine, Semmelweis University, 
      Budapest, Hungary.
FAU - Horvath, Viktor J
AU  - Horvath VJ
AD  - Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis 
      University, Budapest, Hungary.
FAU - Domjan, Beatrix A
AU  - Domjan BA
AD  - Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis 
      University, Budapest, Hungary.
FAU - Zsirai, Laszlo
AU  - Zsirai L
AD  - Department of Gynecology and Family Planning, Istenhegyi Gene Diagnostic Center, 
      Budapest, Hungary.
FAU - Tabak, Adam G
AU  - Tabak AG
AD  - Department of Public Health, Faculty of Medicine, Semmelweis University, 
      Budapest, Hungary.
AD  - Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis 
      University, Budapest, Hungary.
AD  - University College London (UCL) Brain Sciences, University College London, 
      London, United Kingdom.
LA  - eng
GR  - S011676/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230712
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
SB  - IM
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Humans
MH  - Female
MH  - *Pregnancy Outcome/epidemiology
MH  - *Diabetes Mellitus, Type 1/epidemiology
MH  - Cesarean Section
MH  - Stillbirth/epidemiology
MH  - Perinatal Mortality
PMC - PMC10369353
OTO - NOTNLM
OT  - APGAR score
OT  - cesarean section
OT  - neonatal intensive care
OT  - perinatal mortality
OT  - pregnancy
OT  - stillbirth
OT  - trend
OT  - type 1 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/07/28 06:42
MHDA- 2023/07/31 06:43
PMCR- 2023/01/01
CRDT- 2023/07/28 04:06
PHST- 2023/05/31 00:00 [received]
PHST- 2023/06/19 00:00 [accepted]
PHST- 2023/07/31 06:43 [medline]
PHST- 2023/07/28 06:42 [pubmed]
PHST- 2023/07/28 04:06 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2023.1232618 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2023 Jul 12;14:1232618. doi: 
      10.3389/fendo.2023.1232618. eCollection 2023.