Study objective: To determine the degree of centralization and to describe the outcome of all pregnancies among Type 1 (insulin-dependent) mothers in the county of Northern Jutland from 1976-90.
Design: Retrospective, hospital record based study.
Setting: Data were collected from all departments of surgery (n = 8) and obstetrics (n = 3) in the county covering 550,000 inhabitants (approx. 10% of the total Danish population).
Patients: Three hundred and twenty-eight consecutive, unselected pregnancies among 205 women with Type 1 diabetes mellitus admitted to the hospitals in the county from 1976-90.
Main results: Thirty-two (11%) pregnancies were terminated with spontaneous abortions and ten (3.3%) abortions were induced for medical reasons. There were eleven (4.3%) neonatal deaths. There was no additional fetal loss within the first year of life. Eight (3.1%) babies had major and additionally six (2.4%) minor malformations. Total fetal loss was 53/297 = 18%. Twenty-eight percent of the babies were large-for-gestational age. No pregnancies terminated at primary level hospitals and only 6% at the non-sub specialized obstetrical Departments.
Conclusion: We have achieved an almost complete centralization of the management of pregnant women with diabetes mellitus and our outcome is comparable to the results published from other regional surveys taking care of these patients.