Birth weight and fetal death in the United States: the effect of maternal diabetes during pregnancy.

Abstract

Our purpose was to evaluate the association between birth weight (BW) and fetal death (FD) among pregnant nondiabetic and diabetic patients. This was a retrospective cohort study using data for singleton births delivered between 1995 and 1997 in the United States (n = 10, 733, 983). Analysis was restricted to births that occurred at > or =20 completed weeks. FD rates among nondiabetic and diabetic patients (n = 271, 691) were determined for different 250-g BW categories. Adjusted relative risk (RR) and 95% CI for FD among diabetic compared with nondiabetic patients were derived through multivariable logistic regression models after potential confounders were controlled. Overall FD rates for nondiabetic and diabetic patients were 4.0 and 5.9 per 1,000 births, respectively, with adjusted RR of 2.0 (95% CI 1.8-2.2). Maternal diabetes was associated with increased FD rate for all BW categories after 1250 g. The FD rate is increased when birth weight is > or =4250 g in nondiabetic patients and > or =4000 g in diabetic patients.