Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Diabetes Pregnancy Clinic, Auckland City Hospital, Auckland, New Zealand.
Int J Gynaecol Obstet. 2013 Oct;123(1):50-3. doi: 10.1016/j.ijgo.2013.04.022. Epub 2013 Jul 12.
To determine whether differences exist in the rates of obstetric intervention between women with type 1 diabetes and those with type 2 diabetes, and whether there has been any change in cesarean rates over time, paralleling that seen in the general obstetric population.
Data were examined from a prospectively collected series on the outcomes of 1030 deliveries (382 by women with type 1 diabetes, 648 by women with type 2 diabetes) from 1988 to 2008.
There was a secular trend to increasing maternal age (type 1, P < 0.003; type 2, P < 0.03). Intervention rates (induction of labor or elective cesarean) did not differ between type 1 (88%) and type 2 (85%) diabetes. The overall cesarean rate was 52%-55% with no secular trend. Poorer glycemic control in early pregnancy and primiparity were associated with primary cesarean in both groups. In women with type 1 diabetes, greater maternal obesity and retinopathy were also associated with primary cesarean.
Intervention rates are high in pregnancies among women with type 1 diabetes and those with type 2 diabetes but they have not changed significantly. Secular trends toward increasing maternal age and obesity suggest that intervention rates are unlikely to decrease in the near future.
确定 1 型糖尿病和 2 型糖尿病患者的产科干预率是否存在差异，以及剖宫产率是否随时间发生变化，与普通产科人群的变化相平行。
对 1988 年至 2008 年期间 1030 例分娩（382 例 1 型糖尿病妇女，648 例 2 型糖尿病妇女）的前瞻性收集系列数据进行了检查。
存在产妇年龄（1 型糖尿病，P < 0.003；2 型糖尿病，P < 0.03）随时间推移而增加的趋势。1 型（88%）和 2 型（85%）糖尿病之间的干预率（引产或选择性剖宫产）没有差异。总剖宫产率为 52%-55%，没有随时间推移的趋势。两组中，妊娠早期血糖控制较差和初产妇与原发性剖宫产有关。在 1 型糖尿病妇女中，母亲肥胖和视网膜病变也与原发性剖宫产有关。
1 型糖尿病和 2 型糖尿病孕妇的干预率较高，但没有显著变化。产妇年龄和肥胖随时间推移而增加的趋势表明，干预率在不久的将来不太可能降低。
