Pregnancy outcomes in women with type 1 diabetes in China during 2004 to 2014: A retrospective study (the CARNATION Study)

J Diabetes. 2022 Jan;14(1):5-14. doi: 10.1111/1753-0407.13229. Epub 2021 Nov 2.

Abstract
in English, Chinese

Background: We aimed to report pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data were sparse.

Methods: This is a nationwide retrospective study conducted in 11 general medical centers in 8 cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between 1 January 2004 and 31 December 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D.

Results: From over 300 000 pregnancies over the 11-year study period, we identified 265 singleton pregnancies of women with T1D. One maternal death was documented among 265 (0.37%) women with T1D and 83 among 318 486 (0.03%) women without T1D. Women with T1D suffered from higher rates of pregnancy loss (13.21% vs 2.92%, crude risk ratio [cRR] 5.08 [95% CI, 3.56-7.26]) and preeclampsia (17.74% vs 4.20%, cRR 4.94 [95% CI, 3.60-6.77]) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death (5.65% vs 0.16%, cRR 37.36 [95% CI, 21.21-65.82]) and congenital malformation(s) (8.26% vs 3.53%, cRR 2.46 [95% CI, 1.54-3.93]) compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over the period 2004 to 2014.

Conclusions: Pregnancy outcomes were persistently poor in women with T1D during 2004 to 2014 in China. Pregnancy care needs to be improved to reduce adverse pregnancy outcomes among Chinese women with T1D.

背景: 本研究旨在报道中国1型糖尿病(T1D)患者的妊娠结局，该方面相关研究数据较少。 方法: 对全国8个城市的11家综合医疗中心进行回顾性研究。我们调查了2004年1月1日至2014年12月31日期间所有在这些中心就诊的单胎妊娠妇女的临床资料。确定妊娠期T1D的妇女妊娠情况，并与无T1D的妇女进行比较。 结果: 在11年的研究期间，从超过30万例妊娠中，我们鉴定了265例患有T1D的单胎妊娠妇女。265例T1D孕妇中有一例(0.37%)死亡，318486例无T1D孕妇中有83例(0.03%)死亡。与无T1D的女性相比，T1D的女性流产率更高(13.21% vs 2.92%，粗风险比[cRR] 5.08, 95%置信区间[CI] 3.56-7.26)、子痫前期(17.74% vs 4.20%， cRR 4.94, 95% CI 3.60-6.77)。与未患T1D的妇女相比，患有T1D妇女的婴儿新生儿死亡率(5.65% vs 0.16%， cRR 37.36, 95% CI 21.21-65.82)和先天性畸形率(8.26% vs 3.53%， cRR 2.46, 95% CI 1.54-3.93)较高。在2004-2014年间，T1D患者妊娠结局无明显改善。 结论: 2004-2014年中国T1D患者妊娠结局仍然较差。需要改善妊娠护理以减少中国T1D女性的不良妊娠结局。.

Keywords: 1型糖尿病; diabetes mellitus type 1; pregnancy in diabetics; pregnancy outcomes; retrospective study; 回顾性研究; 妊娠结局; 糖尿病患者妊娠.

MeSH terms

  • Diabetes Mellitus, Type 1* / epidemiology
  • Dianthus*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy in Diabetics* / epidemiology
  • Prenatal Care
  • Retrospective Studies