ABSTRACT
In a retrospective study of 19 171 mother-child dyads, elevated random plasma glucose values during early pregnancy were directly correlated with increased risk for congenital heart disease in offspring. Plasma glucose levels proximal to the period of cardiac development may represent a modifiable risk factor for congenital heart disease in expectant mothers without diabetes.
Subject(s)
Blood Glucose/metabolism , Heart Defects, Congenital/etiology , Hyperglycemia/diagnosis , Pregnancy Complications/diagnosis , Pregnancy Trimester, First/blood , Adolescent , Adult , Biomarkers/blood , Female , Humans , Hyperglycemia/blood , Infant, Newborn , Pregnancy , Pregnancy Complications/blood , Retrospective Studies , Risk Factors , Young AdultABSTRACT
OBJECTIVE: To evaluate the amount of antenatal care days in level III hospitals caused by regionalization of very preterm deliveries. STUDY DESIGN: We included all 171,997 pregnancies registered in Finland between January 1, 2004 and December 31, 2006. Data on deliveries from the Medical Birth Register were linked to the Hospital Discharge Register. Maternal zip codes were used to define whether a mother lived inside or outside a level III hospital region. Regionalization was defined as care in level III hospitals between gestational weeks 22 and 32 among mothers living outside level III hospital regions. Pregnancies were divided into 3 groups based on the gestational age at delivery: very preterm (<32 weeks), late preterm (32-36 weeks), and term (≥37 weeks). RESULTS: There were 12,354 antenatal care days in level III hospitals caused by regionalization, which amounts to a need for 12 antenatal maternal beds annually. In the very preterm pregnancies, the antenatal length of stay was comparable for mothers living inside or outside level III hospital regions (median 4 days, P = .81) but significantly longer for mothers living outside level III hospital regions in the late preterm (median 9 vs 7 days, P = .001) and term groups (median 3 vs 2 days, P < .0001). CONCLUSIONS: The costs of regionalization of very preterm deliveries were low, as measured by antenatal care days. Regionalization did not increase the antenatal length of stay in very preterm deliveries.