Zwangerschap bij vrouwen met diabetes mellitus type I: Nog steeds maternale en perinatale complicaties, ondanks goede bloedglucoseregulatie

Objective. To examine the maternal and neonatal outcome of pregnancies of women with type I diabetes mellitus. Design. Retrospective. Methods. The medical records of pregnancies (≥ 16 weeks) in women with type I diabetes mellitus between 1986/'97 were studied in University Medical Center Utrecht, Academic Hospital Groningen and Isala Clinics, location 'De Weezenlanden', Zwolle, the Netherlands. Results. During the study period, 172 women had 220 pregnancies: 212 single and 8 twin pregnancies. The mean age was 29.1 years (SD: 4.1), the mean duration of standing of the diabetes was 12 years (range: 1-32) and the mean concentration of glycosylated haemoglobin (HbA(1c)) was 6.3% at 10 weeks of pregnancy. The incidence of children with congenital malformations was 4 times higher (n = 19; 9.0%) than that in the Dutch population (2%). Macrosomia occurred in 92 children (43.4%) and perinatal mortality in 7 (3.3%). Maternal hypertensive complications occurred in 39 single pregnancies (18.4%), which is 2-3 times more often than in the Dutch population. Conclusion. In type I diabetic women maternal complications, perinatal morbidity and mortality are increased, despite near optimal glycaemic control.