BMJ  2006;333:304 (5 August), doi:10.1136/bmj.333.7562.304-a

Letter

Why do poor outcomes persist in diabetic pregnancy?

The first 150 words of the full text of this article appear below.

EDITOR—Macintosh et al report the continued poor outcome of diabetic pregnancy in the United Kingdom, noting high rates of perinatal mortality and congenital malformation in the babies of women with type 1 and type 2 diabetes.1 We reported some years ago that in our population, perinatal mortality in babies of women with type 2 diabetes was higher than in babies of women with type 1 diabetes.2 Macintosh et al found no such difference and dismiss our findings as "not generalisable."

They seem not to have grasped one of the main points of our study, that in women with type 1 diabetes, perinatal mortality was no different to the background (non-diabetic) rate because pregnancy loss owing to late intrauterine death had become rare in type 1 diabetes. The higher rate of perinatal mortality in the babies of women with type 2 diabetes was largely due to the continued occurrence . . . [Full text of this article]

Tim Cundy, professor of medicine

Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand t.cundy@auckland.ac.nz


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