Reassessment of White's classification and Pedersen's prognostically bad signs of diabetic pregnancies in insulin-dependent diabetic pregnancies

Michael Peter Diamond, Sheron L. Salyer, William K. Vaughn, Robert Cotton, Frank H. Boehm

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

The classification systems developed over 20 years ago by White and Pedersen identified diabetic pregnancies at increased risk for perinatal mortality. To assess whether these same criteria would currently be valid, 199 diabetic pregnancies with deliveries from 1977 to 1983 were reviewed. Perinatal mortality rates for White's Classes B gestational (n = 72), B (n = 27), C (n = 67), and D + F + R (n = 33) were 2.9%, 11.1%, 14.9%, and 21.1%, respectively (p < 0.05). White's classes were also predictive of pulmonary morbidity (12.5%, 18.5%, 22.4%, and 42.4%, respectively). The presence of one or more of the prognostically bad signs of pregnancy (n = 76) increased the perinatal mortality rate to 17.1% versus 7.3% among insulin-dependent diabetic pregnancies without prognostically bad signs (p < 0.05). The presence of any prognostically bad signs of pregnancy was also predictive of pulmonary morbidity in general (31.6% versus 16.3%, respectively) and hyaline membrane disease in particular (13.2% versus 4.1%, respectively). Thus with use of modern obstetric management and medical care of the pregnant diabetic patient, both White's classification and Pedersen's prognostically bad signs of pregnancy continue to be predictive of perinatal mortality.

Original languageEnglish (US)
Pages (from-to)599-604
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume156
Issue number3
DOIs
StatePublished - Jan 1 1987
Externally publishedYes

Keywords

  • Diabetes
  • Pedersen's prognostically bad signs
  • White's classification
  • pregnancy
  • reassessment

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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