Journal Mobile

RS Lindsay, F Mackenzie
Journal Issue: 
Volume 36: Issue 4: 2006




The  recent  CEMACH  report  provides  important  information  on outcomes  and  processes  of  care  for  pregnancy  complicated  by  pre-gestational diabetes in England,Wales and Northern Ireland.  Similar information for Scotland was published previously by the Scottish Diabetes in Pregnancy Study Group. The Confidential Enquiry into Maternal and Child Health found that maternal diabetes was associated with increased rates of stillbirth (4·7-fold), perinatal mortality (3·8-fold), and congenital anomaly (2-fold), compared to pregnancy not complicated by diabetes.   Assessment  of  rates  of  pre-pregnancy  counselling  (documented  in 34·5%), measurement of HbA1c in early pregnancy (38%) and pre-conception folic acid supplementation (39·2%), suggest areas where service development might be concentrated  to  improve  outcomes.   Finally, CEMACH  provides  the  first  large-scale  survey  of  an  increasingly  prevalent  patient  group  –  women  with  type  2 diabetes  in  pregnancy  –  who  made  up  27·2%  of  the  survey  and  showed  similar adverse outcomes to the women with type 1 diabetes.