%0 Journal Article
%T Similar Adverse Pregnancy Outcome in Native and Nonnative Dutch Women with Pregestational Type 2 Diabetes: A Multicentre Retrospective Study
%A Bart Groen
%A Thera P. Links
%A Paul P. van den Berg
%A Marieke Hellinga
%A Sharon Moerman
%A Gerard H. A. Visser
%A Wim J. Sluiter
%A Marijke M. Faas
%A Manon C. J. Schreuder
%A Willy Visser
%A Petronella H. L. M. Geelhoed-Duijvestijn
%A Rutgert Bianchi
%A Anton K. M. Bartelink
%A Harold W. de Valk
%J ISRN Obstetrics and Gynecology
%D 2013
%R 10.1155/2013/361435
%X Objective. To assess the incidence of adverse pregnancy outcome in native and nonnative Dutch women with pregestational type 2 diabetes (T2D) in a multicenter study in The Netherlands. Methods. Maternal characteristics and pregnancy outcome were retrospectively reviewed and the influence of ethnicity on outcome was evaluated using independent -test, Mann-Whitney -test, and chi-square test. Results. 272 pregnant women (80 native and 192 non-native Dutch) with pregestational T2D were included. Overall outcome was unfavourable, with a perinatal mortality of 4.8%, major congenital malformations of 6.3%, preeclampsia of 11%, preterm birth of 19%, birth weight >90th percentile of 32%, and a Caesarean section rate of 42%. In nonnative Dutch women, the glycemic control was slightly poorer and the gestational age at booking somewhat later as compared to native Dutch women. However, there were no differences in incidence of preeclampsia/HELLP, preterm birth, perinatal mortality, macrosomia, and congenital malformations between those two groups. Conclusions. A high incidence of adverse pregnancy outcomes was found in women with pregestational T2D, although the outcome was comparable between native and non-native Dutch women. This suggests that easy access to and adequate participation in the local health care systems contribute to these comparable outcomes, offsetting potential disadvantages in the non-native group. 1. Introduction Pregestational diabetes mellitus comprises both type 1 and type 2 diabetes mellitus. Pregestational type 1 diabetes mellitus is clearly associated with an increased incidence of adverse maternal, fetal, and neonatal outcome [1¨C4], and several studies in the last two decades have shown that pregestational type 2 diabetes poses an emerging problem, with pregnancy outcomes at least as poor as in women with type 1 diabetes [5¨C9]. This gains even more importance in view of the global diabetes epidemic which leads to ever increasing numbers of women in the childbearing age with pregestational type 2 diabetes [5, 10]. To add to the problem, pregestational type 2 diabetes is encountered frequently in specific subpopulations in north-western Europe, such as recently migrated women from Africa, Asia, and the Middle East [11]. These women are possibly more prone to suboptimal participation in the health care system because of frequently existing language barriers, generally less financial resources, and low education levels in those immigrant groups. The Netherlands can be considered as a representative developed European country with ethnic
%U http://www.hindawi.com/journals/isrn.obgyn/2013/361435/