Abstract
Deliveries of pregnant diabetics in hospitals with more than 200 beds throughout Japan during 1971-1975 were surveyed by means of questionnaires.
In 1975, the number of deliveries by diabetics was 157 out of 100, 431 total deliveries, thus makingthe incidence of delivery by diabetics 0.15%.
Out of 364 diabetic females, 377 deliveries (378 off-spring) were reported during the 5 years of the survey, showing a yearly increase. The mean duration of diabetes before delivery was 3.9 years. During pregnancy diabetics, were treated with insulin in 32.4%, oral hypoglycemic agents in 5.6%, and diet alone in 25.2% of the cases. Untreated patients accounted for 3.7%, mixed treatment for 31.8% and unknown for 1.3%.
Perinatal mortality was 10.8% or 41 of 378 fetuses or newborns, with the highest incidence, 35.7%, in the untreated group, 18.8% in the oral hypoglycemic agent group, 13.9%, in the insulin group and 3.4% in the diet group.
Congenital malformations in fetuses and newborns were found in 21 of 378 babies (5.7%). This incidence was highest in the untreated group and lowest in the diet group concerning malformations. There was no significant difference in incidence between groups treated with insulin and oral hypoglycemic agent concerning congenital malformations.
Concerning complications in newborns, hypoglycemia appeared in 13.6%, respiratory distress syndrome in 9.6%, hyperbilirubinemia in 2.5% and hypoglycemia in 1.1%.
The high incidence of perinatal mortality and congenital malformation in untreated groups during pregnancy emphasizes that strict control of diabetes mellitus is very important for pregnant diabetics.
The survey did not give results indicating that the oral hypoglycemic agents were teratogenic.
