Transactions of The Twenty-Second Annual Meeting of The Society for Maternal-Fetal Medicine
Birth weight and fetal death in the United States: The effect of maternal diabetes during pregnancy

Presented at the Twenty-second Annual Meeting of the Society for Maternal-Fetal Medicine, New Orleans, La, January 14-19, 2002.
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Abstract

Objective: Our purpose was to evaluate the association between birth weight (BW) and fetal death (FD) among pregnant nondiabetic and diabetic patients. Study Design: This was a retrospective cohort study using data for singleton births delivered between 1995 and 1997 in the United States (n = 10, 733, 983). Analysis was restricted to births that occurred at ≥20 completed weeks. FD rates among nondiabetic and diabetic patients (n = 271, 691) were determined for different 250-g BW categories. Adjusted relative risk (RR) and 95% CI for FD among diabetic compared with nondiabetic patients were derived through multivariable logistic regression models after potential confounders were controlled. Results: Overall FD rates for nondiabetic and diabetic patients were 4.0 and 5.9 per 1,000 births, respectively, with adjusted RR of 2.0 (95% CI 1.8-2.2). Maternal diabetes was associated with increased FD rate for all BW categories after 1250 g. Conclusion: The FD rate is increased when birth weight is ≥4250 g in nondiabetic patients and ≥4000 g in diabetic patients. ( Am J Obstet Gynecol 2002;187:922-6.)

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Material and methods

This was a population-based, retrospective study assembled by the National Center for Health Statistics of the Centers for Disease Control and Prevention using the national natality and mortality data for US births (1995-1997). The data conform to uniform coding specifications that have been carefully edited, have passed statistical quality checks, and form the basis for official US birth and death statistics. This study was approved by the institutional review board at the University of

Results

The overall fetal death rates among infants of nondiabetic and diabetic patients were 4.0 and 5.9 per 1,000 births, respectively. As shown in Table I, nondiabetic and diabetic patients were clinically comparable with respect to age, gravidity, race/ethnicity, and marital status.

. Demographic data and maternal characteristics of diabetic and nondiabetic patients: United States, 1995-1997

Maternal characteristicsNondiabetics (n = 10,462,292)Diabetics (n = 271,691)
Maternal age (y)*26.8 ± 6.129.8 ± 5.9

Comment

There have been many studies evaluating birth weight as a predictor of survival. Generally, these studies have focused on extremes of weights and have provided evidence to support that these extremes of weights are associated with adverse perinatal outcomes.8 The bulk of studies, however, have focused on the lower end of the spectrum, and it is now well accepted that lower-birth-weight babies, smaller babies, and growth-restricted babies have an increased risk of fetal death.1, 2, 3 In an

References (15)

  • GR Alexander et al.

    A United States national reference for fetal growth

    Obstet Gynecol

    (1996)
  • RM Kliegman et al.

    Strategies for the prevention of low birth weight

    Am J Obstet Gynecol

    (1990)
  • PC Dobson et al.

    Mortality and morbidity of fetal growth retardation

    Aust N Z J Obstet Gynaecol

    (1981)
  • S Cnattingius et al.

    Differences in late fetal death rates in association with determinants of small for gestational age fetuses: population based cohort study

    BMJ

    (1998)
  • I Ahlenius et al.

    The changing panorama of late fetal death in Sweden between 1984 and 1991

    Acta Obstet Gynecol Scand

    (1999)
  • S Taffel et al.

    A method of imputing length of gestation on birth certificates

    Vital Health Stat

    (1982)
  • SM Taffel et al.

    Revised US certificate of birth—new opportunities for research on birth outcome

    Birth

    (1989)
There are more references available in the full text version of this article.

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