Comparison of placental findings in type 1 and type 2 diabetic pregnancies.
Comparison of placental findings in type 1 and type 2 diabetic pregnancies.
- 2014
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.
English
0143-4004
*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 Adult
MedStar Washington Hospital Center
Obstetrics and Gynecology, Maternal-Fetal Medicine
Journal Article
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.
English
0143-4004
*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 Adult
MedStar Washington Hospital Center
Obstetrics and Gynecology, Maternal-Fetal Medicine
Journal Article