Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records
Aim This study aims to investigate pregnancy losses in women with Type 1 or Type 2 diabetes and compare this with the general population. Methods Pregnancies ending between 1993 and 2006 in those with Type 1 or Type 2 diabetes were identified on the General Practice Research Database. Pregnancy loss...
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| Veröffentlicht in: | Diabetic medicine 2014-03, Vol.31 (3), p.357-365 |
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| creator | McGrogan, A. Snowball, J. de Vries, C. S. |
| description | Aim
This study aims to investigate pregnancy losses in women with Type 1 or Type 2 diabetes and compare this with the general population.
Methods
Pregnancies ending between 1993 and 2006 in those with Type 1 or Type 2 diabetes were identified on the General Practice Research Database. Pregnancy losses were identified from medical records and the cohort described by their characteristics and prescribing for diabetes.
Results
Of 2001 pregnancies identified in women with Type 1 diabetes, 678 ended in a pregnancy loss: 19.6% were spontaneous, 9.6% were induced and 4.3% were losses for unknown reasons. In women with Type 2 diabetes, there were 240 losses in 669 pregnancies: 21.1% were spontaneous, 10.3% induced and 4.0% were losses for unknown reasons. The proportion of spontaneous losses in women with diabetes was higher than in the general population (13.2%). Women with Type 1 diabetes treated with human and analogue insulins were 60% more likely to have a delivery than a loss (odds ratio 1.6, 95% CI 1.18–2.18) compared with human insulin treatment alone, although numbers were small.
Conclusion
We found that the proportions of spontaneous losses in women with Type 1 or Type 2 diabetes were similar at approximately 20%, which is higher than in the general population and also higher than previous studies have reported. While much emphasis has been placed on pre‐conception care for women with Type 1 diabetes, the same is now needed for those with Type 2 diabetes, given the similarity in outcomes and increasing prevalence of this condition.
What's new?
Proportions of pregnancies resulting in deliveries and losses in women with Type 2 diabetes were similar to those in women with Type 1 diabetes. Using primary care records we found higher overall proportions of losses than have previously been reported (Type 1 33.4%, Type 2 35.4%) and higher proportions of spontaneous losses (Type 1 19.6%, Type 2 21.1%) than in the general population (13.2%).
Oral treatment of Type 2 diabetes in the 3 months before pregnancy start date or during the first trimester resulted in the highest proportion of spontaneous losses (25%). |
| doi_str_mv | 10.1111/dme.12332 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1837309413</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1837309413</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5222-ea2c91abdb428203c2f86053a7c9ec1d0982992bd71a8a3eb326f24dd1daf5263</originalsourceid><addsrcrecordid>eNqFkUtv1DAUhS0EotPCgj-ALCEkWKT1tZ3EZodKWxAtsGhVdpbj3Exd8hjspGX-PR4yLRISqhd-SN891_ccQl4A24e0DuoO94ELwR-RBchCZrnU8JgsWCl5JlgJO2Q3xmvGgGuhn5IdLlOZVnpBhm8Bl73t3Zq2Q4wYqe_p7dBh2v14Rc_XK6RAhzDfOK29rXCcufEK6cXnd9T26XWDcfRLO_qhp1P0_ZKugu9sWFNnA9KAbgh1fEaeNLaN-Hx77pGL46Pzw4_Z6deTT4fvTzOXc84ztNxpsFVdSa44E443qmC5sKXT6KBmWnGteVWXYJUVWAleNFzWNdS2yXkh9sibWXcVhp9T-prpfHTYtrbHYYoGlCgF0xLEw2gOUvLknXoYlVpDnpfAEvrqH_R6mEKfZt5QSkjQhUzU25lyIbkfsDFb0wwws8nWpGzNn2wT-3KrOFUd1vfkXZgJeL0FbHS2bUKK1ce_nAKlcrUROpi5W9_i-v8dzYezo7vW2Vzh44i_7its-GGKUpS5ufxyYo7T3GfFd20uxW-XH8b5</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1498341964</pqid></control><display><type>article</type><title>Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records</title><source>MEDLINE</source><source>Wiley-Blackwell Full Collection</source><creator>McGrogan, A. ; Snowball, J. ; de Vries, C. S.</creator><creatorcontrib>McGrogan, A. ; Snowball, J. ; de Vries, C. S.</creatorcontrib><description>Aim
This study aims to investigate pregnancy losses in women with Type 1 or Type 2 diabetes and compare this with the general population.
Methods
Pregnancies ending between 1993 and 2006 in those with Type 1 or Type 2 diabetes were identified on the General Practice Research Database. Pregnancy losses were identified from medical records and the cohort described by their characteristics and prescribing for diabetes.
Results
Of 2001 pregnancies identified in women with Type 1 diabetes, 678 ended in a pregnancy loss: 19.6% were spontaneous, 9.6% were induced and 4.3% were losses for unknown reasons. In women with Type 2 diabetes, there were 240 losses in 669 pregnancies: 21.1% were spontaneous, 10.3% induced and 4.0% were losses for unknown reasons. The proportion of spontaneous losses in women with diabetes was higher than in the general population (13.2%). Women with Type 1 diabetes treated with human and analogue insulins were 60% more likely to have a delivery than a loss (odds ratio 1.6, 95% CI 1.18–2.18) compared with human insulin treatment alone, although numbers were small.
Conclusion
We found that the proportions of spontaneous losses in women with Type 1 or Type 2 diabetes were similar at approximately 20%, which is higher than in the general population and also higher than previous studies have reported. While much emphasis has been placed on pre‐conception care for women with Type 1 diabetes, the same is now needed for those with Type 2 diabetes, given the similarity in outcomes and increasing prevalence of this condition.
What's new?
Proportions of pregnancies resulting in deliveries and losses in women with Type 2 diabetes were similar to those in women with Type 1 diabetes. Using primary care records we found higher overall proportions of losses than have previously been reported (Type 1 33.4%, Type 2 35.4%) and higher proportions of spontaneous losses (Type 1 19.6%, Type 2 21.1%) than in the general population (13.2%).
Oral treatment of Type 2 diabetes in the 3 months before pregnancy start date or during the first trimester resulted in the highest proportion of spontaneous losses (25%).</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.12332</identifier><identifier>PMID: 24111989</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Abortion, Induced - statistics & numerical data ; Abortion, Spontaneous - epidemiology ; Adolescent ; Adult ; Biological and medical sciences ; Blood Glucose - metabolism ; Congenital Abnormalities - epidemiology ; Diabetes ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - epidemiology ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes. Impaired glucose tolerance ; Directive Counseling ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Female ; Fetal Death ; Fundamental and applied biological sciences. Psychology ; Glycated Hemoglobin A - metabolism ; Humans ; Infant, Newborn ; Medical sciences ; Patient Education as Topic ; Pregnancy ; Pregnancy Complications - blood ; Pregnancy Complications - epidemiology ; Pregnancy in Diabetics ; Pregnancy Outcome ; Primary Health Care ; Risk Factors ; Stillbirth ; United Kingdom - epidemiology ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>Diabetic medicine, 2014-03, Vol.31 (3), p.357-365</ispartof><rights>2013 The Authors. Diabetic Medicine © 2013 Diabetes UK</rights><rights>2015 INIST-CNRS</rights><rights>2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.</rights><rights>Diabetic Medicine © 2014 Diabetes UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5222-ea2c91abdb428203c2f86053a7c9ec1d0982992bd71a8a3eb326f24dd1daf5263</citedby><cites>FETCH-LOGICAL-c5222-ea2c91abdb428203c2f86053a7c9ec1d0982992bd71a8a3eb326f24dd1daf5263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.12332$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.12332$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28188582$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24111989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McGrogan, A.</creatorcontrib><creatorcontrib>Snowball, J.</creatorcontrib><creatorcontrib>de Vries, C. S.</creatorcontrib><title>Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records</title><title>Diabetic medicine</title><addtitle>Diabet. Med</addtitle><description>Aim
This study aims to investigate pregnancy losses in women with Type 1 or Type 2 diabetes and compare this with the general population.
Methods
Pregnancies ending between 1993 and 2006 in those with Type 1 or Type 2 diabetes were identified on the General Practice Research Database. Pregnancy losses were identified from medical records and the cohort described by their characteristics and prescribing for diabetes.
Results
Of 2001 pregnancies identified in women with Type 1 diabetes, 678 ended in a pregnancy loss: 19.6% were spontaneous, 9.6% were induced and 4.3% were losses for unknown reasons. In women with Type 2 diabetes, there were 240 losses in 669 pregnancies: 21.1% were spontaneous, 10.3% induced and 4.0% were losses for unknown reasons. The proportion of spontaneous losses in women with diabetes was higher than in the general population (13.2%). Women with Type 1 diabetes treated with human and analogue insulins were 60% more likely to have a delivery than a loss (odds ratio 1.6, 95% CI 1.18–2.18) compared with human insulin treatment alone, although numbers were small.
Conclusion
We found that the proportions of spontaneous losses in women with Type 1 or Type 2 diabetes were similar at approximately 20%, which is higher than in the general population and also higher than previous studies have reported. While much emphasis has been placed on pre‐conception care for women with Type 1 diabetes, the same is now needed for those with Type 2 diabetes, given the similarity in outcomes and increasing prevalence of this condition.
What's new?
Proportions of pregnancies resulting in deliveries and losses in women with Type 2 diabetes were similar to those in women with Type 1 diabetes. Using primary care records we found higher overall proportions of losses than have previously been reported (Type 1 33.4%, Type 2 35.4%) and higher proportions of spontaneous losses (Type 1 19.6%, Type 2 21.1%) than in the general population (13.2%).
Oral treatment of Type 2 diabetes in the 3 months before pregnancy start date or during the first trimester resulted in the highest proportion of spontaneous losses (25%).</description><subject>Abortion, Induced - statistics & numerical data</subject><subject>Abortion, Spontaneous - epidemiology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>Congenital Abnormalities - epidemiology</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Directive Counseling</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fetal Death</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Medical sciences</subject><subject>Patient Education as Topic</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - blood</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy in Diabetics</subject><subject>Pregnancy Outcome</subject><subject>Primary Health Care</subject><subject>Risk Factors</subject><subject>Stillbirth</subject><subject>United Kingdom - epidemiology</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EotPCgj-ALCEkWKT1tZ3EZodKWxAtsGhVdpbj3Exd8hjspGX-PR4yLRISqhd-SN891_ccQl4A24e0DuoO94ELwR-RBchCZrnU8JgsWCl5JlgJO2Q3xmvGgGuhn5IdLlOZVnpBhm8Bl73t3Zq2Q4wYqe_p7dBh2v14Rc_XK6RAhzDfOK29rXCcufEK6cXnd9T26XWDcfRLO_qhp1P0_ZKugu9sWFNnA9KAbgh1fEaeNLaN-Hx77pGL46Pzw4_Z6deTT4fvTzOXc84ztNxpsFVdSa44E443qmC5sKXT6KBmWnGteVWXYJUVWAleNFzWNdS2yXkh9sibWXcVhp9T-prpfHTYtrbHYYoGlCgF0xLEw2gOUvLknXoYlVpDnpfAEvrqH_R6mEKfZt5QSkjQhUzU25lyIbkfsDFb0wwws8nWpGzNn2wT-3KrOFUd1vfkXZgJeL0FbHS2bUKK1ce_nAKlcrUROpi5W9_i-v8dzYezo7vW2Vzh44i_7its-GGKUpS5ufxyYo7T3GfFd20uxW-XH8b5</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>McGrogan, A.</creator><creator>Snowball, J.</creator><creator>de Vries, C. S.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201403</creationdate><title>Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records</title><author>McGrogan, A. ; Snowball, J. ; de Vries, C. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5222-ea2c91abdb428203c2f86053a7c9ec1d0982992bd71a8a3eb326f24dd1daf5263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abortion, Induced - statistics & numerical data</topic><topic>Abortion, Spontaneous - epidemiology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - metabolism</topic><topic>Congenital Abnormalities - epidemiology</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Directive Counseling</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fetal Death</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Medical sciences</topic><topic>Patient Education as Topic</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - blood</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy in Diabetics</topic><topic>Pregnancy Outcome</topic><topic>Primary Health Care</topic><topic>Risk Factors</topic><topic>Stillbirth</topic><topic>United Kingdom - epidemiology</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McGrogan, A.</creatorcontrib><creatorcontrib>Snowball, J.</creatorcontrib><creatorcontrib>de Vries, C. S.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McGrogan, A.</au><au>Snowball, J.</au><au>de Vries, C. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet. Med</addtitle><date>2014-03</date><risdate>2014</risdate><volume>31</volume><issue>3</issue><spage>357</spage><epage>365</epage><pages>357-365</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>Aim
This study aims to investigate pregnancy losses in women with Type 1 or Type 2 diabetes and compare this with the general population.
Methods
Pregnancies ending between 1993 and 2006 in those with Type 1 or Type 2 diabetes were identified on the General Practice Research Database. Pregnancy losses were identified from medical records and the cohort described by their characteristics and prescribing for diabetes.
Results
Of 2001 pregnancies identified in women with Type 1 diabetes, 678 ended in a pregnancy loss: 19.6% were spontaneous, 9.6% were induced and 4.3% were losses for unknown reasons. In women with Type 2 diabetes, there were 240 losses in 669 pregnancies: 21.1% were spontaneous, 10.3% induced and 4.0% were losses for unknown reasons. The proportion of spontaneous losses in women with diabetes was higher than in the general population (13.2%). Women with Type 1 diabetes treated with human and analogue insulins were 60% more likely to have a delivery than a loss (odds ratio 1.6, 95% CI 1.18–2.18) compared with human insulin treatment alone, although numbers were small.
Conclusion
We found that the proportions of spontaneous losses in women with Type 1 or Type 2 diabetes were similar at approximately 20%, which is higher than in the general population and also higher than previous studies have reported. While much emphasis has been placed on pre‐conception care for women with Type 1 diabetes, the same is now needed for those with Type 2 diabetes, given the similarity in outcomes and increasing prevalence of this condition.
What's new?
Proportions of pregnancies resulting in deliveries and losses in women with Type 2 diabetes were similar to those in women with Type 1 diabetes. Using primary care records we found higher overall proportions of losses than have previously been reported (Type 1 33.4%, Type 2 35.4%) and higher proportions of spontaneous losses (Type 1 19.6%, Type 2 21.1%) than in the general population (13.2%).
Oral treatment of Type 2 diabetes in the 3 months before pregnancy start date or during the first trimester resulted in the highest proportion of spontaneous losses (25%).</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>24111989</pmid><doi>10.1111/dme.12332</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Diabetic medicine, 2014-03, Vol.31 (3), p.357-365 |
| issn | 0742-3071 1464-5491 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1837309413 |
| source | MEDLINE; Wiley-Blackwell Full Collection |
| subjects | Abortion, Induced - statistics & numerical data Abortion, Spontaneous - epidemiology Adolescent Adult Biological and medical sciences Blood Glucose - metabolism Congenital Abnormalities - epidemiology Diabetes Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology Diabetes. Impaired glucose tolerance Directive Counseling Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Female Fetal Death Fundamental and applied biological sciences. Psychology Glycated Hemoglobin A - metabolism Humans Infant, Newborn Medical sciences Patient Education as Topic Pregnancy Pregnancy Complications - blood Pregnancy Complications - epidemiology Pregnancy in Diabetics Pregnancy Outcome Primary Health Care Risk Factors Stillbirth United Kingdom - epidemiology Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | Pregnancy losses in women with Type 1 or Type 2 diabetes in the UK: an investigation using primary care records |
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