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Published online June 22, 2007
Diabetes Care 30:2496-2498, 2007
DOI: 10.2337/dc07-0364
© 2007 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Article

Prepregnancy Diabetes and Risk of Placental Vascular Disease

Taryn Becker, MD, FRCPC1, Marian J. Vermeulen, BSCN, MHSC2, Philip R. Wyatt, MD, FRCPC, PHD3, Chris Meier, BSC, MBA4 and Joel G. Ray, MD, MSC, FRCPC5

1 Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
2 Institute for Clinical Evaluative Sciences, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
3 Department of Genetics, York Central Hospital, Richmond Hill, Ontario, Canada
4 St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
5 Divisions of Endocrinology and Metabolism and General Internal Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada

Address correspondence and reprint requests to Dr. Taryn Becker, c/o Dr. Joel G. Ray, St. Michael's Hospital, University of Toronto, 30 Bond St., Toronto, Ontario, Canada M5B 1W8. E-mail: rayj@smh.toronto.on.ca

Abbreviations: MSS, maternal serum screening

The first 20% of the full text of this article appears below.


   INTRODUCTION
 
Maternal diabetes before pregnancy is associated with adverse maternal and perinatal outcomes, including acquired hypertension during pregnancy (1,2,3). The maternal placental syndromes preeclampsia and abruption or infarction of the placenta (4) are also more prevalent in women with insulin resistance, diabetes, and the metabolic syndrome (3,5–8). We evaluated the risk of placental vascular disease in association with prepregnancy diabetes.


   RESEARCH DESIGN AND METHODS—
 
We completed a retrospective population-based study of all women who underwent antenatal maternal serum screening (MSS) in Ontario, Canada, between 1993 and 2000, as described elsewhere (9). Those with a multiple gestation pregnancy at the time of MSS were excluded.

Maternal characteristics (Table 1) were recorded on a standardized form and completed by the patients’ caregivers at the time of MSS. Data on obstetrical outcomes and the health status of each newborn were also linked to the Discharge Abstract Database of the Canadian Institute for Health Information, providing up to eight ICD-9 diagnostic codes for each woman and each newborn (see the online appendix [available at http://dx.doi.org/10.2337/dc07-0364]).


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  		Table 1— Characteristics of women with and without prepregnancy diabetes and risk of adverse placental and perinatal outcomes

 
The primary study outcome was a diagnosis of either preeclampsia and abruption or infarction, according to the relevant ICD-9 codes recorded at the delivery hospital (online appendix). . . . [Full Text of this Article]

Statistical analysis

   RESULTS—
 

   CONCLUSIONS—
 

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Copyright © 2007 by the American Diabetes Association.