Diabetes mellitus as a cause of adverse perinatal outcomes and complications in newborns


DOI: https://dx.doi.org/10.18565/therapy.2020.1.44-50

Sviridova M.I., Stryuk R.I., Chekanova A.V., Kandalina V.V.

1) Center of endocrinological diseases of pregnant women of City clinical Hospital No 29 named after N.E. Bauman of Moscow Healthcare Department; 2) A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia
Purpose: analysis of perinatal outcomes and newborn condition in women with different types of diabetes mellitus in actual clinical practice.
Material and methods. Based on the study of histories of disease and childbirth 434 patients’ aged from 19 to 43 years (mean age of 31,03 ±4,85 years) who was under observation of the perinatal Center for women with endocrinological problems based hospital No 29 in the period 2016–2017, had done the analysis of the course of pregnancy, perinatal outcomes and newborn condition. As the result, in 137 cases (41,0%) was diagnosed gestational diabetes mellitus (GDM, group 1), 115 (34,4%) – 1st type diabetes mellitus (DM 1, group 2), 82 (24,6%) – 2nd type diabetes mellitus (DM 2, group 3) and 100 women - without diabetes (normoglycemia) (group 4).
Results. Found that 25% of women with GDM and 40% with DM 2 are in the category of «age» pregnant women, so, most of them has obesity, pathological weight gain during gestation and preeclampsia. But active observation, compliance of the necessary diet, glycemic control, insulin therapy, if necessary, contributed to the compensation of DM, which led to the prolongation of pregnancy to terms close to physiological. However, 77% of pregnant women with DM 1 and 43% with DM 2 were delivered by caesarean section.
Conclusion. The main negative consequences for the newborn, mainly from mothers with DM 1 and DM 2 and less often with GDM, were fetal macrosomy, diabetic fetopathy, neonatal hypoglycemia, diabetic cardiopathy, which occurred in newborns despite sufficient mothers’ compensation of DM.
Keywords: newborn condition, perinatal outcomes, gestational diabetes mellitus, type 1 diabetes mellitus, type 2 diabetes mellitus, pregnancy
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Literature


  1. Российский статистический ежегодник. 2018: Стат.сб. Росстат. Р76. Москва, 2018; 694 с.

  2. International Diabetes Federation. IDF Diabetes Atlas. Download the 7-th Edition of the Diabetes Atlas. Accessed December 9, 2017. http:/www.idf.org/diabetesatlas

  3. Стрюк Р.И., Бернс С.А., Филиппова М.П., Брыткова Я.В., Борисов И.В., Гомова Т.А., Козина Е.А., Нагирняк О.А. Сердечно-сосудистые заболевания и ассоциированные с ними коморбидные состояния как факторы, определяющие неблагоприятные перинатальные исходы при беременности – анализ результатов регистра беременных «БЕРЕГ». Терапевтический архив. 2018; 90(1): 9–16. [Stryuk R.I., Berns S.A., Filippova M.P. et al. Cardiovascular disease and associated comorbid conditions as determinants of adverse perinatal outcomes in pregnancy – an analysis of the results of the register of pregnant BEREG. 2018; 90(1): 9–16 (In Russ.)]. doi: https://doi.org/10.26442/terarkh20189019-16.

  4. Мирошник Е.В., Рюмина И.И., Зубков В.В. Влияние сахарного диабета матери на здоровье новорожденного. Акушерство и гинекология. 2016; 9: 45–46. [Miroshnik E.V., Ryumina I.I., Zubkov V.V. Impact of maternal diabetes mellitus on neonatal health. 2016; 9: 45–46 (In Russ)]. doi: https://dx.doi.org/10.18565/aig.2016.9.45-9.

  5. Abell S.K., Boyle J.A., de Courten B., Knight M., Ranasinha S., Regan J., Soldatos G., Wallace E.M., Zoungas S., Teede H.J. Contemporary type 1 diabetes pregnancy outcomes impact of obesity and glucoemic control. Med J Aust. 2016; 205(4): 162–67. doi: 10.5694/mja16.00443.

  6. Акушерство. Национальное руководство. Под ред. Г.М. Савельевой, Г.Т. Сухих, В.Н. Серова, В.Е. Радзинского. 2-е изд. доп. и перераб. М.: ГЭОТАР-Медиа, 2018; 1088 с.

  7. Неонатология: Национальное руководство /под ред. Н.Н. Володина М.: ГЭОТАР-Медиа, 2008; 848 c.

  8. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 9-й выпуск. М.: УП ПРИНТ; 2019. doi: 10.14341/DM221S1.

  9. Powe C.E., Tobias D.K., Michels K.B. et al. History of gestational diabetes mellitus and risk of incident invasive breast cancer among parous women in the Nurses’ Health Study II prospective cohort. Cancer Epidemiol Biomarkers Prev. 2017; 26(3): 321–27. doi: 10.1158/1055-9965.EPI-16-0601.

  10. Kim C., Newton K.M., Knopp R.H. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002; 25(10): 1862–68. doi.org/10.2337/diacare.25.10.1862.

  11. Савельева Г.М., Шалина Р.И., Коноплянников А.Г., Симухина М.А. Преэклампсия и эклампсия: новые подходы к диагностике и оценке степени тяжести. Акушерство и гинекология: новости, мнения, обучение. 2018; 4(6): 25–30. doi: 10.24411/2303-9698-2018-14002. [Savelieva G.M., Shalina R.I., Konoplyannikov A.G., Simukhina M.A. Pre-eclampsia and eclampsia: new approaches in diagnostics and evaluation of severity. Akusherstvo i ginecologiya: novosti, mneniya, obuchenie. 2018; 4 (6): 25–30 (In Russ)]. doi: 10.24411/2303-9698-2018-14002.

  12. Kotori V.M., Djelmis J., Ivanisevic M. Perinatal outcome and frequency of congenital malformations in pregnancy complicated with diabetes type 1 and type 2. Open Journal of Obstetrics and Gynecology. 2016; 6: 122–28. doi: 10.4236/ojog.2016.62015

  13. Радзинский В.Е., Князев С.А. Сократить долю кесаревых сечений. Настоятельные рекомендации ВОЗ о снижении доли кесаревых сечений. Status Praesens гинекология и акушерство. 2015; 3(26): 11–20.

  14. Murphy H.R., Bell R., Cartwright C. et al. Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic to clinic variations: a prospective nation study Diabetologia. 2017 Sep; 60(9): 1668–77. doi: 10.1007/s00125-017-4314-3.

  15. Руководство по детской эндокринологии: пер. с англ. Под ред. Ч.Г.Д. Брук, Р.С. Браун. М.: ГЭОТАР Медиа, 2009; 352 с.

  16. Таранушенко Т.Е., Киселева Н.Г., Устинова С.И., Салмина А.Б., Анциферова Е.В. Транзиторные гипогликемии у новорожденных детей. Педиатрия (Прил. к журн. Consilium Medicum). 2017; 1: 45–49. [Taranushenko T.E., Kiseleva N.G., Ustinova S.I. et al. Transient hypoglycemia in newborns. Pediatrics (Suppl. Consilium Medicum). 2017; 1: 45–49 (In Russ.)].

  17. Нейман Е.Г., Шитьковская Е.П., Ильенкова Н.А., Чикунов В.В., Прокопцева Н.Л. Особенности неонатального периода у детей, рожденных от матерей с сахарным диабетом. Сибирское медицинское обозрение. 2014; 4; 75–78. [Neyman E.G., Shit'kovskaya E.P., Ilienkova N.A. et al. Features of the neonatal period in infants born to mothers with diabetes. Sibirskoe medicinskoe obozrenie. 2014; 4; 75–78 (In Russ.)].


About the Autors

Maria I. Sviridova, PhD, head of Center of endocrinological diseases of pregnant women of City clinical Hospital No 29 named after N.E. Bauman of Moscow Healthcare Department. Address: 111020, Moscow, 2 Gospitalnaya Sq. Tel.: +7 (903) 628-73-73. E-mail: marysadoc@rambler.ru
Raisa I. Stryuk, MD, professor, honored doctor of the Russian Federation, head of the Department of internal medicine of the Faculty of dentistry of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. Tel.: +7 (903) 565-73-88. E-mail: rstryuk@list.ru
Anastasia V. Chekanova, endocrinologist of Center of endocrinological diseases of pregnant women of City clinical Hospital No 29 named after N.E. Bauman of Moscow Healthcare Department. Address: 111020, Moscow, 2 Gospitalnaya Sq. Tel.: +7 (903) 556-79-28. E-mail: аnastasiya-murzina@mail.ru
Violetta V. Kandalina, endocrinologist of Center of endocrinological diseases of pregnant women of City clinical Hospital No 29 named after N.E. Bauman of Moscow Healthcare Department. Address: 111020, Moscow, 2 Gospitalnaya Sq. Tel.: +7 (916) 124-85-99. E-mail: kandalna.viola@yandex.ru


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