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Association between outcome of pregnancy and glycaemic control in early pregnancy in type 1 diabetes: population based study

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7375.1275 (Published 30 November 2002) Cite this as: BMJ 2002;325:1275
  1. Rosemary Temple, consultant physicican (rosemary.temple@Norfolk-norwich.thenhs.com)a,
  2. Vivien Aldridge, diabetes nurse specialista,
  3. Richard Greenwood, consultant physiciana,
  4. Philip Heyburn, consultant physiciana,
  5. Michael Sampson, consultant physiciana,
  6. Katharine Stanley, consultant obstetricianb
  1. a Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich NR4 7UY,
  2. b East Anglia Centre for Fetal and Maternal Medicine, Norfolkand Norwich University Hospital NHS Trust
  1. Correspondence to: R Temple
  • Accepted 22 April 2002

Recent studies of pregnancy in women in the United Kingdom with type 1 diabetes have shown a fourfold to tenfold increased risk of congenital malformation and a fivefold increased risk of perinatal mortality compared with non-diabetic women. 1 2 These studies used different measures of glycaemic control (concentrations of glycated haemoglobin and fructosamine) both within and between centres so no conclusions were reached about the relation between outcome and glycaemic control. We conducted a population study examining the relation between glycaemic control in early pregnancy and outcome of pregnancy in women with type 1 diabetes.

Participants, methods, and results

This observational study was carried out in a single centre in Norwich from January 1991 to December 2000. The resident population is 510 000 and mainly white. We defined adverse pregnancy outcome as spontaneous abortion (first or second trimester), major congenital malformation (potentially life threatening …

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