French Multicentric Survey of Outcome of Pregnancy in Women With Pregestational Diabetes

French Multicentric Survey of Outcome of Pregnancy in Women With Pregestational Diabetes Diabetes and Pregnancy Group, France Address correspondence and reprint requests to Jacques Lepercq, MD, Service de Gynécologie-Obstétrique, Hôpital Cochin-Saint Vincent de Paul, 82, Avenue Denfert-Rochereau, 75674 Paris cedex 14, France. E-mail: j.lepercq{at}svp.ap-hop-paris.fr Abstract OBJECTIVE —To evaluate perinatal outcome in pregnancies in women with type 1 and type 2 diabetes and the influence of preconception care 10 years after the St. Vincent’s declaration. RESEARCH DESIGN AND METHODS —A cross-sectional study was conducted in 12 perinatal centers in France in 2000-2001. The main investigated outcomes were perinatal mortality, major congenital malformations, and preterm delivery. RESULTS —Among 435 single pregnancies, 289 (66.4%) were from women with type 1 and 146 (33.6%) from women with type 2 diabetes. Perinatal mortality rate was 4.4% (0.7% national rate), severe congenital malformations rate was 4.1% (2.2% national rate), and preterm delivery rate was 38.2% (4.7% national rate). Preconception care was provided in 48.5% women with type 1 diabetes and in 24.0% women with type 2 diabetes. Women whose first trimester HbA 1c was >8% had higher rates of perinatal mortality (9.2 vs. 2.5%; odds ratio 3.9; 95% CI 1.5–9.7; P < 0.005), major congenital malformations (8.3 vs. 2.5%; 3.5; 1.3–8.9; P < 0.01), and preterm delivery (57.6 vs. 24.8%; 1.4; 1.1–1.7; P < 0.005) than those with first trimester HbA 1c