Diabetes und Schwangerschaft

Aktualisierungshinweis

Die DDG-Praxisempfehlungen werden regelmäßig zur zweiten Jahreshälfte aktualisiert. Bitte stellen Sie sicher, dass Sie jeweils die neueste Version lesen und zitieren.

Publication History

Article published online:
21 November 2024

• Literatur

• 1 Lee TTM, Collet C, Bergford S. et al. Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes. N Engl J Med 2023; 389: 1566-1578
• 2 American College of Obstetricians and Gynecologists (ACOG). ACOG Committee Opinion number 315, September 2005. Obesity in pregnancy. Obstet Gynecol 2005; 106: 671-675
• 3 Barbour LA. Changing perspectives in pre-existing diabetes and obesity in pregnancy: Maternal and infant short- and long-term outcomes. Curr Opin Endocrinol Diabetes Obes 2014; 21: 257-263
• 4 Metwally M, Ong KJ, Ledger WL. et al. Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril 2008; 90: 714-726
• 5 der Steeg JW, Steures P, Eijkemans MJC. et al. Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. Hum Reprod 2008; 23: 324-328
• 6 Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG). S2k-Leitlinie Prävention und Therapie der Frühgeburtlichkeit Version 1.0. Stand Februar 2019. 2018 Accessed June 13, 2020 at: https://www.awmf.org/leitlinien/detail/ll/015–025.html
• 7 Araujo J, Brandão LAC, Guimarães RL. et al. Prevalence of autoimmune thyroid disease and thyroid dysfunction in young Brazilian patients with type 1 diabetes. Pediatr Diabetes 2008; 9: 272-276
• 8 Dittmar M, Kahaly GJ. Polyglandular autoimmune syndromes: Immunogenetics and long-term follow-up. J Clin Endocrinol Metab 2003; 88: 2983-2992
• 9 Hunger-Battefeld W, Fath K, Mandecka A. et al. Prävalenz eines polyglandulären Autoimmunsyndroms bei Patienten mit Diabetes mellitus Typ 1. Med Klin (Munich) 2009; 104: 183-191
• 10 Rabe M, Groten T, Dawczynski K. et al. Tranzplazentarer Autoantikörpertransfer bei Schwangeren mit Typ 1 Diabetes mellitus bzw. polyglandulärem Autoimmunsyndrom. Diabetol Stoffwechs 2015; 10: 322-328
• 11 Bell R, Glinianaia SV, Tennant PWG. et al. Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes: A population-based cohort study. Diabetologia 2012; 55: 936-947
• 12 Cyganek K, Skupien J, Katra B. et al. Risk of macrosomia remains glucosedependent in a cohort of women with pregestational type 1 diabetes and good glycemic control. Endocrine 2017; 55: 447-455
• 13 Holmes VA, Young IS, Patterson CC. et al. Optimal glycemic control, preeclampsia, and gestational hypertension in women with type 1 diabetes in the diabetes and pre-eclampsia intervention trial. Diabetes Care 2011; 34: 1683-1688
• 14 Ludvigsson JF, Neovius M, Söderling J. et al. Maternal Glycemic Control in Type 1 Diabetes and the Risk for Preterm Birth: A Population-Based Cohort Study. Ann Intern Med 2019; 170: 691-701
• 15 Tennant PWG, Glinianaia SV, Bilous RW. et al. Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: A population-based study. Diabetologia 2014; 57: 285-294
• 16 Feig DS, Corcoy R, Donovan LE. et al. Pumps or Multiple Daily Injections in Pregnancy Involving Type 1 Diabetes: A Prespecified Analysis of the CONCEPTT Randomized Trial. Diabetes Care 2018; 41: 2471-2479
• 17 Glinianaia SV, Tennant PWG, Bilous RW. et al. HbA_1c and birthweight in women with pre-conception type 1 and type 2 diabetes: A populationbased cohort study. Diabetologia 2012; 55: 3193-3203
• 18 Mackin ST, Nelson SM, Wild SH. et al. Factors associated with stillbirth in women with diabetes. Diabetologia 2019; 62: 1938-1947
• 19 Björklund AO, Adamson UK, Almström NH. et al. Effects of hypoglycaemia on fetal heart activity and umbilical artery Doppler velocity waveforms in pregnant women with insulin-dependent diabetes mellitus. Br J Obstet Gynaecol 1996; 103: 413-420
• 20 Naik D, Hesarghatta Shyamasunder A, Doddabelavangala Mruthyunjaya M. et al. Masked hypoglycemia in pregnancy. J Diabetes 2017; 9: 778-786
• 21 Reece EA, Hagay Z, Roberts AB. et al. Fetal Doppler and behavioral responses during hypoglycemia induced with the insulin clamp technique in pregnant diabetic women. Am J Obstet Gynecol 1995; 172: 151-155
• 22 Braak EWMT, Evers IM, Willem Erkelens D. et al. Maternal hypoglycemia during pregnancy in type 1 diabetes: Maternal and fetal consequences. Diabetes Metab Res Rev 2002; 18: 96-105
• 23 Lorenzen T, Pociot F, Johannesen J. et al. A population-based survey of frequencies of self-reported spontaneous and induced abortions in Danish women with Type 1 diabetes mellitus. Danish IDDM Epidemiology and Genetics Group. Diabet Med 1999; 16: 472-476
• 24 Mills JL. Malformations in infants of diabetic mothers. Teratology 1982; 25: 385-394
• 25 Rosenn B, Miodovnik M, Combs CA. et al. Glycemic thresholds for spontaneous abortion and congenital malformations in insulin-dependent diabetes mellitus. Obstet Gynecol 1994; 84: 515-520
• 26 Sutherland HW, Pritchard CW. Increased incidence of spontaneous abortion in pregnancies complicated by maternal diabetes mellitus. Am J Obstet Gynecol 1987; 156: 135-138
• 27 Becerra JE, Khoury MJ, Cordero JF. et al. Diabetes mellitus during pregnancy and the risks for specific birth defects: A population-based casecontrol study. Pediatrics 1990; 85: 1-9
• 28 Chou H-H, Chiou M-J, Liang F-W. et al. Association of maternal chronic disease with risk of congenital heart disease in offspring. CMAJ 2016; 188: E438-E446
• 29 Zhao E, Zhang Y, Zeng X. et al. Association between maternal diabetes mellitus and the risk of congenital malformations: A meta-analysis of cohort studies. Drug Discov Ther 2015; 9: 274-281
• 30 Vinceti M, Malagoli C, Rothman KJ. et al. Risk of birth defects associated with maternal pregestational diabetes. Eur J Epidemiol 2014; 29: 411-418
• 31 Callec R, Perdriolle-Galet E, Sery G-A. et al. Type 2 diabetes in pregnancy: Rates of fetal malformations and level of preconception care. J Obstet Gynaecol 2014; 34: 648-649
• 32 Evers IM, Valk HW de, Visser GHA. Risk of complications of pregnancy in women with type 1 diabetes: Nationwide prospective study in the Netherlands. BMJ 2004; 328: 915
• 33 Hoang TT, Marengo LK, Mitchell LE. et al. Original Findings and Updated Meta-Analysis for the Association Between Maternal Diabetes and Risk for Congenital Heart Disease Phenotypes. Am J Epidemiol 2017; 186: 118-128
• 34 Liu S, Joseph KS, Lisonkova S. et al. Association between maternal chronic conditions and congenital heart defects: A population-based cohort study. Circulation 2013; 128: 583-589
• 35 Schaefer-Graf UM, Buchanan TA, Xiang A. et al. Patterns of congenital anomalies and relationship to initial maternal fasting glucose levels in pregnancies complicated by type 2 and gestational diabetes. Am J Obstet Gynecol 2000; 182: 313-320
• 36 Simeone RM, Devine OJ, Marcinkevage JA. et al. Diabetes and congenital heart defects: A systematic review, meta-analysis, and modeling project. Am J Prev Med 2015; 48: 195-204
• 37 Slot A, Eriksen NB, Ringholm L. et al. Congenital heart defects in offspring of women with Type 2 diabetes – a systematic review. Dan Med J 2019; 66: A5543
• 38 Martínez-Frías ML, Rodríguez-Pinilla E, Bermejo E. et al. Epidemiological evidence that maternal diabetes does not appear to increase the risk for Down syndrome. Am J Med Genet 2002; 112: 335-337
• 39 Wu Y, Liu B, Sun Y. et al. Association of Maternal Prepregnancy Diabetes and Gestational Diabetes Mellitus With Congenital Anomalies of the Newborn. Diabetes Care 2020; 43: 2983-2990
• 40 Correa A, Botto L, Liu Y. et al. Do multivitamin supplements attenuate the risk for diabetes-associated birth defects?. Pediatrics 2003; 111: 1146-1151
• 41 Jovanovic L, Knopp RH, Kim H. et al. Elevated pregnancy losses at high and low extremes of maternal glucose in early normal and diabetic pregnancy: Evidence for a protective adaptation in diabetes. Diabetes Care 2005; 28: 1113-1117
• 42 Xiang LJ, Wang Y, Lu G-Y. et al. Association of the presence of microangiopathy with adverse pregnancy outcome in type 1 diabetes: A metaanalysis. Taiwan J Obstet Gynecol 2018; 57: 659-664
• 43 Acolet D. Description of the babies and Standards of care for the babies. In: Macintosh M, Hrsg. Pregnancy in Women with Type 1 and Type 2 Diabetes in 2002–2003, England, Wales and Northern Ireland. London: CEMACH; 2005: 37–49. Accessed June 28, 2022 at: https://elearning.rcog.org.uk//sites/default/files/Diabetes%20and%20other%20endocrinopathies/CEMACH_Pregnancy_type_1_2_diabetes.pdf
• 44 Boulot P, Chabbert-Buffet N, d’Ercole C. et al. French multicentric survey of outcome of pregnancy in women with pregestational diabetes. Diabetes Care 2003; 26: 2990-2993
• 45 Chaudhry T, Ghani AM, Mehrali TH. et al. A comparison of foetal and labour outcomes in Caucasian and Afro-Caribbean women with diabetes in pregnancy. Int J Clin Pract 2004; 58: 932-936
• 46 Clausen TD, Mathiesen E, Ekbom P. et al. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care 2005; 28: 323-328
• 47 Cundy T, Gamble G, Townend K. et al. Perinatal mortality in Type 2 diabetes mellitus. Diabet Med 2000; 17: 33-39
• 48 Dunne F, Brydon P, Smith K. et al. Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002. Diabet Med 2003; 20: 734-738
• 49 Poston L, Caleyachetty R, Cnattingius S. et al. Preconceptional and maternal obesity: Epidemiology and health consequences. Lancet Diabetes Endocrinol 2016; 4: 1025-1236
• 50 American Diabetes Association (ADA). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43 (Suppl. 01) S14-S31
• 51 Harreiter J, Simmons D, Desoye G. et al. IADPSG and WHO 2013 Gestational Diabetes Mellitus Criteria Identify Obese Women With Marked Insulin Resistance in Early Pregnancy. Diabetes Care 2016; 39: e90-e92
• 52 Ray JG, O’Brien TE, Chan WS. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: A meta-analysis. QJM 2001; 94: 435-444
• 53 Garcia-Patterson A, Corcoy R, Rigla M. et al. Does preconceptional counselling in diabetic women influence perinatal outcome?. Ann Ist Super Sanita 1997; 33: 333-336
• 54 Willhoite MB, Bennert HW JR, Palomaki GE. et al. The impact of preconception counseling on pregnancy outcomes. The experience of the Maine Diabetes in Pregnancy Program. Diabetes Care 1993; 16: 450-455
• 55 American Diabetes Association (ADA). 13. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018; 41 (Suppl. 01) S137-S143
• 56 Lindsay RS, Loeken MR. Metformin use in pregnancy: Promises and uncertainties. Diabetologia 2017; 60: 1612-1619
• 57 Balsells M, Garcia-Patterson A, Sola I. et al. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: A systematic review and meta-analysis. BMJ 2015; 350: h102
• 58 Camelo Castillo W, Boggess K, Stürmer T. et al. Association of Adverse Pregnancy Outcomes With Glyburide vs Insulin in Women With Gestational Diabetes. JAMA Pediatr 2015; 169: 452-458
• 59 National Institute for Health and Care Excellence (NICE). Diabetes in Pregnancy: Management of Diabetes and Its Complications from Preconception to the Postnatal Period. NICE guideline (NG 3). 2015
• 60 Ainuddin JA, Karim N, Zaheer S. et al. Metformin treatment in type 2 diabetes in pregnancy: An active controlled, parallel-group, randomized, open label study in patients with type 2 diabetes in pregnancy. J Diabetes Res 2015; 2015: 325851
• 61 Tieu J, Coat S, Hague W. et al. Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes. Cochrane Database Syst Rev 2017; 10: CD007724
• 62 Rowan JA, Rush EC, Obolonkin V. et al. Metformin in gestational diabetes: The offspring follow-up (MiG TOFU): body composition at 2 years of age. Diabetes Care 2011; 34: 2279-2284
• 63 Rowan JA, Rush EC, Plank LD. et al. Metformin in gestational diabetes: The offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7–9 years of age. BMJ Open Diabetes Res Care 2018; 6: e000456
• 64 Hanem LGE, Stridsklev S, Juliusson PB. et al. Metformin Use in PCOS Pregnancies Increases the Risk of Offspring Overweight at 4 Years of Age: Follow-Up of Two RCTs. J Clin Endocrinol Metab 2018; 103: 1612-1621
• 65 Tarry-Adkins JL, Aiken CE, Ozanne SE. Neonatal, infant, and childhood growth following metformin versus insulin treatment for gestational diabetes: A systematic review and meta-analysis. PLoS Med 2019; 16: e1002848
• 66 Feig DS, Donovan LE, Zinman B. et al. Metformin in women with type 2 diabetes in pregnancy (MiTy): A multicentre, international, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2020; 8: 834-844
• 67 Zhang R, Han S, Chen G-C. et al. Effects of low-glycemic-index diets in pregnancy on maternal and newborn outcomes in pregnant women: A meta-analysis of randomized controlled trials. Eur J Nutr 2018; 57: 167-177
• 68 Gilbert C, Valois M, Koren G. Pregnancy outcome after first-trimester exposure to metformin: A meta-analysis. Fertil Steril 2006; 86: 658-663
• 69 Norgaard SK, Nichum VL, Barfred C. et al. Use of the smartphone application “Pregnant with Diabetes”. Dan Med J 2017; 64: A5417
• 70 Blumer I, Hadar E, Hadden DR. et al. Diabetes and pregnancy: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013; 98: 4227-4249
• 71 Brown J, Ceysens G, Boulvain M. Exercise for pregnant women with preexisting diabetes for improving maternal and fetal outcomes. Cochrane Database Syst Rev 2017; 12: CD012696
• 72 American Diabetes Association (ADA). 14. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43 (Suppl. 01) S183-S192
• 73 Mackensen F, Paulus WE, Max R. et al. Ocular changes during pregnancy. Dtsch Arztebl Int 2014; 111: 567-575
• 74 Joint British Diabetes Societies for Inpatient Care (JBDS-IP). Management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units: May 2017. 2017 Accessed July 12, 2021 at: https://www.diabetes.org.uk/professionals/resources/shared-practice/inpatient-and-hospital-care/joint-british-diabetes-society-for-inpatientcare/management-of-glycaemic-control-in-pregnant-women-withdiabetes-on-obstetric-wards-and-delivery-units