[Course of pregnancy of insulin-dependent diabetic patients 1978-1985 at the 1st Vienna University gynecologic clinic].
Perinatal mortality and morbidity in infants of diabetic mothers have declined continuously during the past decades, due to advances in prenatal care, obstetric management and intensive neonatal care. This retrospective study reports on complications during pregnancy and fetal outcome in those insulin-dependent-diabetic (IDDM) pregnancies admitted to our institution from 1978 to 1985. Age, weight, prepregnant weight and weight-gain of those patients are compared with normal uncomplicated pregnancies (of the same period). In the diabetic group we noticed a high incidence of abortion (30%) as well as a high frequency of previous stillbirths (19%). In the majority of cases delivery was achieved by the 38th week of gestation the mean birth weight and length being 3,144 g and 48.5 cm respectively. 22% of the cases were delivered by cesarean section. The diagnosis preeclampsia was made in 15 patients, in 4 cases we observed a placental insufficiency, 11 women presented with premature labor and there was one fetal death. 44 newborns (63.8%) had a birthweight between 2,500 g and 4,000 g, 15 infants were below 2,500 g (21.7%), 10 infants weighed more than 4,000 g (14.5%), 5 of them displayed cushingoid features. 3 cases were complicated by hypoglycemia, 3 infants were dystrophic at birth and there was one major congenital anomaly. The incidence of neonatal respiratory distress syndrome was extremely high, 12 milder cases could be managed without ventilation therapy, 4 severe cases had to be given full respiratory support.