Groen Bart, Links Thera P, van den Berg Paul P, Hellinga Marieke, Moerman Sharon, Visser Gerard H A, Sluiter Wim J, Faas Marijke M, Schreuder Manon C J, Visser Willy, Geelhoed-Duijvestijn Petronella H L M, Bianchi Rutgert, Bartelink Anton K M, de Valk Harold W
Department of Endocrinology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ; Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
ISRN Obstet Gynecol. 2013 Oct 30;2013:361435. doi: 10.1155/2013/361435. eCollection 2013.
Objective. To assess the incidence of adverse pregnancy outcome in native and nonnative Dutch women with pregestational type 2 diabetes (T2D) in a multicenter study in The Netherlands. Methods. Maternal characteristics and pregnancy outcome were retrospectively reviewed and the influence of ethnicity on outcome was evaluated using independent t-test, Mann-Whitney U-test, and chi-square test. Results. 272 pregnant women (80 native and 192 non-native Dutch) with pregestational T2D were included. Overall outcome was unfavourable, with a perinatal mortality of 4.8%, major congenital malformations of 6.3%, preeclampsia of 11%, preterm birth of 19%, birth weight >90th percentile of 32%, and a Caesarean section rate of 42%. In nonnative Dutch women, the glycemic control was slightly poorer and the gestational age at booking somewhat later as compared to native Dutch women. However, there were no differences in incidence of preeclampsia/HELLP, preterm birth, perinatal mortality, macrosomia, and congenital malformations between those two groups. Conclusions. A high incidence of adverse pregnancy outcomes was found in women with pregestational T2D, although the outcome was comparable between native and non-native Dutch women. This suggests that easy access to and adequate participation in the local health care systems contribute to these comparable outcomes, offsetting potential disadvantages in the non-native group.
目的。在荷兰的一项多中心研究中,评估患有孕前2型糖尿病(T2D)的荷兰本土和非本土女性不良妊娠结局的发生率。方法。回顾性分析孕产妇特征和妊娠结局,并使用独立t检验、曼-惠特尼U检验和卡方检验评估种族对结局的影响。结果。纳入了272例患有孕前T2D的孕妇(80例荷兰本土孕妇和192例非荷兰本土孕妇)。总体结局不佳,围产期死亡率为4.8%,严重先天性畸形率为6.3%,子痫前期发生率为11%,早产率为19%,出生体重>第90百分位数的比例为32%,剖宫产率为42%。与荷兰本土女性相比,非荷兰本土女性的血糖控制略差,首次产前检查时的孕周稍晚。然而,两组之间子痫前期/溶血、肝酶升高和血小板减少综合征(HELLP)、早产、围产期死亡率、巨大儿和先天性畸形的发生率没有差异。结论。患有孕前T2D的女性不良妊娠结局发生率较高,尽管荷兰本土和非本土女性的结局相当。这表明,方便获得并充分参与当地医疗保健系统有助于取得这些相当的结局,抵消了非本土群体的潜在劣势。