Comparison of placental findings in type 1 and type 2 diabetic pregnancies.

MedStar author(s):
Citation: Placenta. 35(12):1001-6, 2014 Dec.PMID: 25458965Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology, Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Blood Glucose | *Diabetes Mellitus, Type 1/pa [Pathology] | *Diabetes Mellitus, Type 2/pa [Pathology] | *Placenta/pa [Pathology] | *Pregnancy in Diabetics/pa [Pathology] | Adult | Diabetes Mellitus, Type 1/bl [Blood] | Diabetes Mellitus, Type 1/co [Complications] | Diabetes Mellitus, Type 2/bl [Blood] | Diabetes Mellitus, Type 2/co [Complications] | Female | Fetal Macrosomia/et [Etiology] | Fetal Macrosomia/pa [Pathology] | Humans | Infant, Newborn | Pre-Eclampsia/bl [Blood] | Pre-Eclampsia/et [Etiology] | Pre-Eclampsia/pa [Pathology] | Pregnancy | Pregnancy in Diabetics/bl [Blood] | Pregnancy Outcome | Retrospective Studies | Young AdultYear: 2014ISSN:
  • 0143-4004
Name of journal: PlacentaAbstract: DISCUSSION: Both types of pregestational diabetes have significant impact on placental growth and development. The comparison between the two groups suggests different pathogenetic mechanisms and may be helpful for better management of diabetic pregnancy.Copyright � 2014 Elsevier Ltd. All rights reserved.INTRODUCTION: The aim of this study is to compare placental pathology and related clinical parameters between gravidas with type 1 and type 2 pregestational diabetes.METHODS: This is a retrospective cohort study of women with singleton gestations and pregestational diabetes who delivered at Women and Infants Hospital from 2003 to 2011. Pathology reports, maternal and neonatal outcomes were extracted and compared between the two groups.RESULTS: In our cohort, 293 pregnancies were studied, including 117 with type 1 diabetes and 176 with type 2 diabetes. Women with type 1 diabetes had worse glycemic control during pregnancy, as characterized by higher HbA1c values and average fasting and postprandial blood sugars. More infants from the type 1 group were admitted to Neonatal ICU. Pregestational diabetes led to small for gestational age (SGA) placentas in nearly 20% pregnancies and large for gestational age (LGA) placentas in 30% of cases. Both groups shared similar incidences of preeclampsia and significant placental pathology related to uteroplacental (maternal) and fetal circulatory disorders; however, maternal decidual vasculopathy and placentas with insufficiency (fetal-to-placental weight ratio < 10th %tile) were more commonly found in placentas from women with type 2 diabetes.All authors: Chen K, Coviello E, He M, Inman K, Lopes V, Pinar H, Starikov RFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-01-13
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Journal Article MedStar Authors Catalog Article 25458965 Available 25458965

DISCUSSION: Both types of pregestational diabetes have significant impact on placental growth and development. The comparison between the two groups suggests different pathogenetic mechanisms and may be helpful for better management of diabetic pregnancy.Copyright � 2014 Elsevier Ltd. All rights reserved.

INTRODUCTION: The aim of this study is to compare placental pathology and related clinical parameters between gravidas with type 1 and type 2 pregestational diabetes.

METHODS: This is a retrospective cohort study of women with singleton gestations and pregestational diabetes who delivered at Women and Infants Hospital from 2003 to 2011. Pathology reports, maternal and neonatal outcomes were extracted and compared between the two groups.

RESULTS: In our cohort, 293 pregnancies were studied, including 117 with type 1 diabetes and 176 with type 2 diabetes. Women with type 1 diabetes had worse glycemic control during pregnancy, as characterized by higher HbA1c values and average fasting and postprandial blood sugars. More infants from the type 1 group were admitted to Neonatal ICU. Pregestational diabetes led to small for gestational age (SGA) placentas in nearly 20% pregnancies and large for gestational age (LGA) placentas in 30% of cases. Both groups shared similar incidences of preeclampsia and significant placental pathology related to uteroplacental (maternal) and fetal circulatory disorders; however, maternal decidual vasculopathy and placentas with insufficiency (fetal-to-placental weight ratio < 10th %tile) were more commonly found in placentas from women with type 2 diabetes.

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