Obstetric outcomes in pregnant women with diabetes versus hypertensive disorders versus both.
J Matern Fetal Neonatal Med
; 25(4): 385-8, 2012 Apr.
Article
em En
| MEDLINE
| ID: mdl-21627547
ABSTRACT
OBJECTIVE:
To compare obstetrical outcomes in pregnant women with diabetes versus hypertensive disorders versus both.METHODS:
One million patients in the New Jersey Database were analyzed. Of which 6.91% had hypertension, 4.79% had diabetes, and 0.91% had both. Information was derived from a perinatal linked data-set provided by the Maternal Child Health Epidemiology (MCH Epi) Program in the New Jersey Department of Health and Senior Services. Linking of electronic birth certificates, hospital discharge records for mother and newborn, and infant death certificates for all infants born in New Jersey between the years 1997 and 2005 created the data-set.RESULTS:
Coexistence of hypertension and diabetes increased with advancing maternal age (OR 3.41; CI 3.12-3.72). Among ethnic groups, diabetes was more common in Asians (OR 2.92; CI 2.84-3.00), while hypertension was more common in Blacks (OR 1.49; CI 1.46-1.53). Blacks followed by Asians had a higher risk of being in the combined category. Induction of labor (OR 4.16; CI 3.96-4.38), shoulder dystocia (OR 2.56; CI 2.05-3.19), operative vaginal delivery (OR 3.92; CI 3.29-4.66), cesarean deliveries with no trial of labor (OR 2.54; CI 2.40-2.69) as well as with failed trial of labor (OR 4.09; CI 3.88-4.31) were more common in the combined group. Neonatal outcomes were poor in the combined category, with high rate of preterm deliveries, neonatal intensive care unit (NICU) admissions (OR 2.14; CI 2.01-2.28), neonatal seizures (OR 2.30; CI 1.31-4.04), low 5-min APGAR scores (OR 1.78; CI 1.57-2.01), and longer NICU stay (OR 2.30; CI 2.15-2.47).CONCLUSIONS:
Coexistence of hypertension and diabetes was associated with worse obstetric and neonatal outcomes than either alone. This should be emphasized to mothers during prenatal counseling. Further research should focus on interventions to improve morbidity in the combined category.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
Gravidez em Diabéticas
/
Resultado da Gravidez
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Parto Obstétrico
/
Hipertensão
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article