ObstetricsPreterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies☆,☆☆
Section snippets
Material and methods
The study population consisted of women enrolled in protocols that were designed and carried out by members of the Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development.6, 11 The study group included women with singleton pregnancies who had pregestational diabetes mellitus requiring insulin therapy or preexisting chronic hypertension and were enrolled in a multicenter randomized trial to compare low-dose aspirin with placebo for the prevention of
Results
Table I compares the baseline clinical characteristics among the 3 study groups.Empty Cell Pregestational diabetes mellitus (n = 461) Chronic hypertension (n = 761) Control (n = 2738) Statistical significance Race (%) P <.0001 White 52.5 26.8 35.3 Black 39.3 60.8 62.8 Married (%) 46.6 40.9 27.1 P <.0001 Multiparous (%) 49.7 75.3 56.9 P <.0001 Maternal age (y, mean ± SD) 25.9 ± 6.0 29.8 ± 6.3 23.5 ± 5.4 P <.0001 Maternal weight (lb, mean ± SD) 163.3 ± 46.7 194.1 ± 58.9 147.9 ± 40.0 P
Comment
In this study we evaluated the rates of and the reasons for preterm delivery in a large population of women with pregestational diabetes mellitus treated with insulin or chronic hypertension and compared them with those in a healthy control woman. The rates of preterm delivery at both <37 weeks’ gestation and <35 weeks’ gestation were significantly higher in the study groups than in the control group. Among women with pregestational diabetes mellitus treated with insulin the rate of preterm
Acknowledgements
The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network was established by the Institute in 1986. In addition to the authors, the participants in the Network were as follows: J. Harger, M. Cotroneo, and T. Kamon, Magee-Women’s Hospital, Pittsburgh; B. Mercer and R. Ramsey, University of Tennessee, Memphis; Y. Rabello, D. McCart, and E. Mueller, University of Southern California, Los Angeles; R. Goldenberg and R. Copper, University of Alabama,
References (13)
- et al.
Prematurity among insulin-requiring diabetic gravid women
Am J Obstet Gynecol
(1989) - et al.
Diabetic nephropathy: pregnancy performance and fetomaternal outcome
Am J Obstet Gynecol
(1988) - et al.
The prognosis of pregnancy in women with chronic hypertension
Am J Obstet Gynecol
(1994) - et al.
Maternal hypertension and spontaneous preterm births among black women
Obstet Gynecol
(1998) - et al.
The preterm prediction study: fetal fibronectin testing and spontaneous preterm birth. NICHD Maternal Fetal Medicine Units Network
Obstet Gynecol
(1996) - et al.
The preterm prediction study: risk factors for indicated preterm births. Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development
Am J Obstet Gynecol
(1998)
Cited by (0)
- ☆
Supported by grants HD 19897, HD21410, HD21414, HD21434, HD27860, HD27861, HD27869, HD27883, HD27889, HD27905, HD27915, HD27917, and HD36801 from the National Institute of Child Health and Human Development.
- ☆☆
Reprint requests: Baha M. Sibai, MD, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, 231 Bethesda Ave, Rm 4415, Cincinnati, OH 45267.