Reassessment of White's classification and Pedersen's prognostically bad signs of diabetic pregnancies in insulin-dependent diabetic pregnancies |
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| Authors: | M P Diamond S L Salyer W K Vaughn R Cotton F H Boehm |
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| Institution: | 1. Division of Biostatistics, Vanderbilt University Medical Center Nashville, Tennessee, USA.;2. the Department of Obstetrics and Gynecology, Vanderbilt University Medical Center Nashville, Tennessee, USA.;3. the Department of Pediatrics, Vanderbilt University Medical Center Nashville, Tennessee, USA.;1. Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan 84156-83111, Iran;2. Animal Science Research Department; Isfahan Agriculture and Natural Resources Research and Education Center; Agriculture Research, Education and Extension Organization (AREEO), 8174835117, Isfahan, Iran;3. Department of Animal Science, Campus of Agriculture and Natural Resources, University of Tehran, 31587-77871, Karaj, Iran;4. Department of Animal Science, Agricultural Sciences and Natural Resources, University of Khuzestan, 63417-73637, Mollasani, Ahvaz, Iran;5. Department of Eco-friendly Livestock Science, Institute of Green Bio Science and Technology, Seoul National University, Pyeongchang, 25354, South Korea;1. College of Chemistry and Chemical Engineering, Wuhan Textile University, Fangzhi Road, 1, Wuhan 430073, China;2. IMDEA Materials Institute, C/Eric Kandel, 2, Getafe 28906, Madrid, Spain;3. Leibniz-Institut für Polymer for schung Dresden e. V., Hohe Street, 6, Dresden 01069, Germany;4. School of Materials Science & Engineering, Beijing Institute of Fashion Technology, Beijing 100029, China;1. Rural Development Theory and Policy, Hans-Ruthenberg-Institute, University of Hohenheim (490A), Wollgrasweg 43, Stuttgart 70599, Germany;2. Julius Kühn-Institut (JKI), Federal Research Centre for Cultivated Plants, Institute for Strategies and Technology Assessment, Stahnsdorfer Damm 81, 14532 Kleinmachnow, Germany;3. Institute of Farm Management, Computer Applications and Business Management in Agriculture, University of Hohenheim (410C), Schwerzstraße 46, 70593 Stuttgart, Germany;1. State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, 2699 Qianjin Street, Changchun 130012, China;2. College of Instrumentation and Electrical Engineering, Jilin University, Changchun 130061, China;1. Center for Bioprocess Engineering, Department of Chemical and Biochemical Engineering, Building 229, Technical University of Denmark, 2800 Kongens Lyngby, Denmark;2. Composites Engineering, School of Engineering, Plymouth University, Drake Circus, Plymouth, Devon PL4 8AA, United Kingdom |
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| Abstract: | The classification systems developed over 20 years ago by White and Pedersen identified diabetic pregnancies at increased risk for perinatal mortality. To assess whether these same criteria would currently be valid, 199 diabetic pregnancies with deliveries from 1977 to 1983 were reviewed. Perinatal mortality rates for White's Classes B gestational (n = 72), B (n = 27), C (n = 67), and D + F + R (n = 33) were 2.9%, 11.1%, 14.9%, and 21.1%, respectively (p less than 0.05). White's classes were also predictive of pulmonary morbidity (12.5%, 18.5%, 22.4%, and 42.4%, respectively). The presence of one or more of the prognostically bad signs of pregnancy (n = 76) increased the perinatal mortality rate to 17.1% versus 7.3% among insulin-dependent diabetic pregnancies without prognostically bad signs (p less than 0.05). The presence of any prognostically bad signs of pregnancy was also predictive of pulmonary morbidity in general (31.6% versus 16.3%, respectively) and hyaline membrane disease in particular (13.2% versus 4.1%, respectively). Thus with use of modern obstetric management and medical care of the pregnant diabetic patient, both White's classification and Pedersen's prognostically bad signs of pregnancy continue to be predictive of perinatal mortality. |
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