Dunne F P, Avalos G, Durkan M, Mitchell Y, Gallacher T, Keenan M, Hogan M, Carmody L A, Gaffney G
School of Medicine, National University of Ireland, Galway.
Ir Med J. 2012 May;105(5 Suppl):6-9.
ATLANTIC DIP prospectively evaluated the perinatal and maternal outcomes of pregnancies complicated by Type 1 and Type 2 diabetes during 2006/2007 in 5 antenatal centres. All women with established diabetes for at least 6 months prior to the index pregnancy and booking for antenatal care between 1/1/2006 and 31/12/2007 were included in the study. Results were collected electronically via the DIAMOND Diabetes Information System. Pregnancy outcome was compared with that of the background population receiving antenatal care in the region during the same time. There were 104 singleton pregnancies during the period of study. The stillbirth rate (SBR) of 25/1000 was 5 times greater than that reported in the background population at 5/1000 and the perinatal mortality rate (PMR) of 25/1000 was 3.5 times greater than background 7/1000. The congenital malformation rate (CMR) of 24/1000 was twice that observed in the background population. Women were not well prepared for pregnancy with 28% receiving pre pregnancy care (PPC), 43% receiving pre pregnancy folic acid and 51% achieving a HbA1C < = 7% at first antenatal visit. Pregnancy induced hypertension (PIH) and/or pre eclampsia toxaemia (PET) were three times more common than in women in the background population. In conclusion women are not well prepared for pregnancy. Maternal and infant morbidity and infant mortality are greater in women with diabetes. A regional pre pregnancy care (PPC) programme and centralised glucose management are urgently needed.
“大西洋糖尿病妊娠研究（ATLANTIC DIP）”前瞻性评估了2006/2007年间5个产前中心中患有1型和2型糖尿病的孕妇的围产期及母体结局。所有在本次妊娠前已确诊糖尿病至少6个月且于2006年1月1日至2007年12月31日期间预约产前检查的妇女均纳入本研究。结果通过钻石糖尿病信息系统以电子方式收集。将妊娠结局与同期该地区接受产前检查的背景人群的结局进行比较。研究期间共有104例单胎妊娠。死产率（SBR）为25/1000，是背景人群中报告的5/1000的5倍，围产儿死亡率（PMR）为25/1000，是背景人群中7/1000的3.5倍。先天性畸形率（CMR）为24/1000，是背景人群中观察到的两倍。妇女对妊娠准备不足，28%的妇女接受了孕前护理（PPC），43%的妇女服用了孕前叶酸，51%的妇女在首次产前检查时糖化血红蛋白（HbA1C）≤7%。妊娠高血压（PIH）和/或子痫前期毒血症（PET）的发生率是背景人群中妇女的3倍。总之，妇女对妊娠准备不足。糖尿病妇女的母婴发病率和婴儿死亡率更高。迫切需要一个地区性的孕前护理（PPC）项目和集中化的血糖管理。
