Table of Contents Author Guidelines Submit a Manuscript
The Scientific World Journal
Volume 2013, Article ID 254901, 9 pages
http://dx.doi.org/10.1155/2013/254901
Review Article

An Update on Diabetic Women Obstetrical Outcomes Linked to Preconception and Pregnancy Glycemic Profile: A Systematic Literature Review

1Department of Woman and Child Health, University of Padua, Via Giustiniani 3, 35128 Padua, Italy
2Department of Surgical Sciences, University of Parma, Parma, Italy
3Dipartimento di Scienze Chirurgiche, U.O.C. di Ginecologia e Ostetricia, Via Gramsci 14, 43100 Parma, Italy

Received 12 August 2013; Accepted 24 September 2013

Academic Editors: J. L. Bartha and S. F. Wong

Copyright © 2013 Salvatore Gizzo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Women with type 2 diabetes were less likely to have diabetes related complications than women with type 1. Women with type 1 diabetes had a high prepregnancy care and showed a worse glycemic control than women with type 2 both in the preconception period and during pregnancy. Obstetrical outcomes showed that preeclampsia and stillbirth rate is almost doubled in type 1 patients while perinatal deaths and SGA importantly increased in type 2 diabetes. In modern obstetrical care it is mandatory to maintain glucose levels as close to normal as possible particularly in diabetic population. HbA1C no higher than 6% before pregnancy and during the first trimester seems to decrease the risk of adverse obstetrical outcomes. Both the preconceptional counseling and glycemic profile optimization represent a fundamental step to improve pregnancy outcomes in women with preexisting diabetes. A systematic approach to family planning and the availability of preconception care for all diabetic women who desire pregnancy could be an essential step for diabetic management program.