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Fertility outcomes in women with pre-existing type 2 diabetes—a prospective cohort study

Mattsson, Kristina LU ; Nilsson-Condori, Emma LU orcid ; Elmerstig, Eva ; Vassard, Ditte ; Schmidt, Lone ; Ziebe, Søren and Jöud, Anna LU orcid (2021) In Fertility and Sterility 116(2). p.505-513
Abstract

Objective: To study childbirth and the risk of miscarriage and infertility among women who have received a diagnosis of type 2 diabetes before the start of their reproductive journey. Design: Register-based cohort study using the Skåne Healthcare Register Setting: All healthcare visits for the whole population of the southernmost region in Sweden over the past 20 years Patient(s): All women who were aged 18–45 years between January 1, 1998 and December 31, 2019 and who received a clinical diagnosis of type 2 diabetes before their first childbirth, miscarriage, or infertility diagnosis (n = 230) were compared with a healthcare-seeking population of women without any type of diabetes, matched for calendar year and age (n = 179,434).... (More)

Objective: To study childbirth and the risk of miscarriage and infertility among women who have received a diagnosis of type 2 diabetes before the start of their reproductive journey. Design: Register-based cohort study using the Skåne Healthcare Register Setting: All healthcare visits for the whole population of the southernmost region in Sweden over the past 20 years Patient(s): All women who were aged 18–45 years between January 1, 1998 and December 31, 2019 and who received a clinical diagnosis of type 2 diabetes before their first childbirth, miscarriage, or infertility diagnosis (n = 230) were compared with a healthcare-seeking population of women without any type of diabetes, matched for calendar year and age (n = 179,434). Intervention(s): None Main Outcome Measure(s): Childbirth, miscarriage, and infertility diagnosis Result(s): The birthrate was lower among women with type 2 diabetes (62.6% vs. 83.8%), and they were less likely to give birth (crude risk ratio [RR] = 0.73, 95% confidence interval [CI]: 0.66–0.81). They had a higher risk of experiencing a miscarriage (RR = 1.88, 95% CI: 1.50–2.36). The risk of infertility was increased (RR = 3.44, 95% CI: 2.88–4.10) as was the risk of having infertility and not giving birth (RR = 4.47, 95% CI: 3.44–5.82). All results remained the same after adjustment for polycystic ovary syndrome and obesity. Conclusion(s): Women with type 2 diabetes with onset before their reproductive journey were more often childless compared with women without diabetes and had a higher risk of experiencing both miscarriage and infertility. This patient group may be in need of targeted information regarding potential fertility issues as part of their clinical treatment.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Birthrate, female reproduction, fertility, infertility, miscarriage, type 2 diabetes mellitus
in
Fertility and Sterility
volume
116
issue
2
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85111611039
  • pmid:34353572
ISSN
0015-0282
DOI
10.1016/j.fertnstert.2021.02.009
language
English
LU publication?
yes
id
95d1116f-3b9d-4ab2-8b91-1028c752167a
date added to LUP
2021-08-27 11:43:42
date last changed
2024-06-15 15:13:51
@article{95d1116f-3b9d-4ab2-8b91-1028c752167a,
  abstract     = {{<p>Objective: To study childbirth and the risk of miscarriage and infertility among women who have received a diagnosis of type 2 diabetes before the start of their reproductive journey. Design: Register-based cohort study using the Skåne Healthcare Register Setting: All healthcare visits for the whole population of the southernmost region in Sweden over the past 20 years Patient(s): All women who were aged 18–45 years between January 1, 1998 and December 31, 2019 and who received a clinical diagnosis of type 2 diabetes before their first childbirth, miscarriage, or infertility diagnosis (n = 230) were compared with a healthcare-seeking population of women without any type of diabetes, matched for calendar year and age (n = 179,434). Intervention(s): None Main Outcome Measure(s): Childbirth, miscarriage, and infertility diagnosis Result(s): The birthrate was lower among women with type 2 diabetes (62.6% vs. 83.8%), and they were less likely to give birth (crude risk ratio [RR] = 0.73, 95% confidence interval [CI]: 0.66–0.81). They had a higher risk of experiencing a miscarriage (RR = 1.88, 95% CI: 1.50–2.36). The risk of infertility was increased (RR = 3.44, 95% CI: 2.88–4.10) as was the risk of having infertility and not giving birth (RR = 4.47, 95% CI: 3.44–5.82). All results remained the same after adjustment for polycystic ovary syndrome and obesity. Conclusion(s): Women with type 2 diabetes with onset before their reproductive journey were more often childless compared with women without diabetes and had a higher risk of experiencing both miscarriage and infertility. This patient group may be in need of targeted information regarding potential fertility issues as part of their clinical treatment.</p>}},
  author       = {{Mattsson, Kristina and Nilsson-Condori, Emma and Elmerstig, Eva and Vassard, Ditte and Schmidt, Lone and Ziebe, Søren and Jöud, Anna}},
  issn         = {{0015-0282}},
  keywords     = {{Birthrate; female reproduction; fertility; infertility; miscarriage; type 2 diabetes mellitus}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{505--513}},
  publisher    = {{Elsevier}},
  series       = {{Fertility and Sterility}},
  title        = {{Fertility outcomes in women with pre-existing type 2 diabetes—a prospective cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.fertnstert.2021.02.009}},
  doi          = {{10.1016/j.fertnstert.2021.02.009}},
  volume       = {{116}},
  year         = {{2021}},
}