From May 1974 to March 1989, 48 cases of pregestational
diabetes mellitus treated during the third trimester of pregnancy at the Obstetric Clinic of the National Taiwan University Hospital had complete maternal-fetal chart, and were enrolled into this retrospective review. Of these cases, 28 were class B, 13 were class C and seven were class D-R. The maternal complications and perinatal morbidities of each class were reviewed. The mean fasting, postprandial plasma
glucose concentrations and the mean excursion of plasma
glucose levels were calculated for statistical analysis. Among the maternal complications,
urinary tract infections and
preterm labor were significantly associated with mean fasting plasma
glucose concentrations. Among perinatal morbidities, neonatal respiratory distress and metabolic problems (including
neonatal hyperbilirubinemia, symptomatic
hypoglycemia,
hypocalcemia and
polycythemia) were significantly associated with mean plasma fasting
glucose concentrations, and perinatal
asphyxia was associated with a mean excursion of plasma
glucose levels. In view of the paucity of knowledge about the etiology of complications in diabetic pregnancies, it is necessary to conduct a prospective multi-center study with well-characterized morbidities to search for the role of
glycemic control in obstetric and perinatal complications.