Perinatal and infant mortality in term and preterm births among women with type 1 diabetes

Diabetologia. 2011 Nov;54(11):2771-8. doi: 10.1007/s00125-011-2281-7. Epub 2011 Aug 25.


Aims/hypothesis: The aim of this study was to estimate the risks of adverse birth outcomes such as stillbirth, infant death, preterm birth and pre-eclampsia in women with type 1 diabetes, compared with the background population. We further aimed to explore the risks of adverse birth outcomes in preterm and term deliveries separately.

Methods: By linkage of two nationwide registries, the Medical Birth Registry of Norway and the Norwegian Childhood Diabetes Registry, we identified 1,307 births among women with pregestational type 1 diabetes registered in the Diabetes Registry, and 1,161,092 births in the background population during the period 1985-2004. The ORs with 95% CIs for adverse outcome among women with type 1 diabetes vs the background population were estimated using logistic regression.

Results: The OR for stillbirth (≥22 weeks of gestation) was 3.6 (95% CI 2.5, 5.3), and for perinatal death (stillbirth or death in the first week of life) it was 2.9 (95% CI 2.0, 4.1). The OR for infant death (first year of life) was 1.9 (95% CI 1.1, 3.2). For preterm birth (< 37 weeks of gestation) and pre-eclampsia the ORs were 4.9 (95% CI 4.3, 5.5) and 6.3 (95% CI 5.5, 7.2), respectively. When preterm and term deliveries were analysed separately, the excess risk of stillbirth and infant death in women with diabetes was confined to term deliveries.

Conclusions/interpretation: Pregestational type 1 diabetes was associated with a considerably higher risk of adverse pregnancy outcomes, including infant death, compared with the background population. A novel finding of the study was that the increased risk was confined to term births.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / mortality*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Female
  • Humans
  • Infant
  • Infant Mortality*
  • Infant, Newborn
  • Male
  • Maternal Mortality
  • Norway / epidemiology
  • Perinatal Mortality*
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy in Diabetics / mortality*
  • Premature Birth*
  • Registries
  • Risk
  • Stillbirth / epidemiology
  • Term Birth*
  • Young Adult