Discrepancy in term calculation from second trimester ultrasound scan versus last menstrual period in women with type 1 diabetes. (13th June 2014)

• Record Type: Journal Article
• Authors: Eidem, Ingvild; Vangen, Siri; Henriksen, Tore; Vollset, Stein E.; Hanssen, Kristian F.; Joner, Geir; Stene, Lars C.
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 8(2014)
• Page Start: 809
• Page End: 816
• Publication Date: 2014-06-13
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12422
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12422-abs-0001"> <title>Abstract</title> <sec id="aogs12422-sec-0001" sec-type="section"> <title>Objective</title> <p>To study differences in ultrasound‐based compared to menstrual‐based term estimation in women with type 1 diabetes.</p> </sec> <sec id="aogs12422-sec-0002" sec-type="section"> <title>Design</title> <p>Nationwide register study.</p> </sec> <sec id="aogs12422-sec-0003" sec-type="section"> <title>Setting</title> <p>Norway.</p> </sec> <sec id="aogs12422-sec-0004" sec-type="section"> <title>Population</title> <p>Deliveries in Norway 1999–2004 by women registered in the Norwegian Childhood Diabetes Registry (<italic>n</italic> = 342) and the background population (<italic>n</italic> = 307 248), with data on both ultrasound‐based and menstrual‐based gestational age notified in the Birth Registry of Norway. Births with major malformations were excluded.</p> </sec> <sec id="aogs12422-sec-0005" sec-type="section"> <title>Methods</title> <p>Linkage of two nationwide registries, the Medical Birth Registry of Norway and the Norwegian Childhood Diabetes Registry.</p> </sec> <sec id="aogs12422-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Estimated gestational age at delivery based on routine second trimester ultrasound measurements and last menstrual period.</p> </sec> <sec id="aogs12422-sec-0007" sec-type="section"> <title>Results</title> <p>In women with type 1 diabetes, the distribution of gestational age at delivery was shifted considerably towards a lower gestational age when using second trimester ultrasound data for estimation, compared with last menstrual period data. The difference between the two estimation methods was larger among women with type 1 diabetes, although also evident in the general population. One in four women with diabetes and a certain last menstrual period date had their ultrasound‐calculated term postponed 1 week or more, while one in 10 had it postponed 2 weeks or more. Corresponding numbers in the background population were one in five and one in 20.</p> </sec> <sec id="aogs12422-sec-0008" sec-type="section"> <title>Conclusions</title> <p>We found a systematic postponement of ultrasound‐based compared with menstrual‐based term estimation in women with type 1 diabetes. Relying solely on routine ultrasound‐based term calculation for delivery decision may imply a risk of going beyond an optimal pregnancy length.</p> </sec> </abstract>