OBJECTIVE Type 2 diabetes (T2D) now accounts for the majority of pre-existing diabetes affecting pregnancy in the UK. Our aim was to determine its impact on pregnancy outcomes compared to type 1 diabetes (T1D), gestational diabetes (GDM) and non-diabetes pregnancies. DATA SOURCES PubMed was searched 1 January 2009-2024. STUDY ELIGIBILITY CRITERIA Cohort observational studies reporting original data on at least one of the primary outcomes in ten or more T2D pregnancies were eligible for inclusion. Comparative diabetes and non-diabetes pregnancies were also collected. STUDY APPRAISAL AND SYNTHESIS METHODS Primary outcomes included congenital anomalies, stillbirths, neonatal and perinatal mortality, birthweight, rates of large for gestational age (LGA), small for gestational age (SGA) and macrosomia. PROSPERO ID CRD42023411057. RESULTS 47 studies were analysed. The number of pregnancies in each analysis varied depending on the available data from the outcome being analysed but ranged from 723 to 4,469,053 pregnancies. When compared with T1D pregnancies, T2D were more likely to have SGA babies as well as greater neonatal and perinatal mortality (OR 2.29, 95% CI 1.12 - 4.67; OR 1.53 95% CI 1.20 to 1.94 and OR 1.31 95% CI 1.07 to 1.61 respectively). When compared with GDM, T2D were more likely to have babies with congenital anomalies (OR 1.91, 95% CI 1.04 - 3.50), LGA (OR 3.49, 95% CI 2.49 to 4.89), neonatal mortality (OR 3.96, 95% CI 3.38 to 4.64) and stillbirth (OR 16.55, 95% CI 5.69 to 48.11). In comparison to non-diabetic pregnancy, T2D were more likely to have babies with congenital anomalies (OR 1.76, 95% CI 1.11 - 2.79), LGA (OR 2.79, 95% CI 1.93 to 4.04), perinatal mortality (OR 4.18, 95% CI 2.91 to 6.01) and stillbirth (OR 7.27, 95% CI 3.01 to 17.53). CONCLUSIONS T2D pregnancies are associated with a greater perinatal mortality than other forms of diabetes in pregnancy. Given its increasing prevenance, greater awareness of the adverse pregnancy outcomes associated with T2D is needed, by both healthcare providers and policy makers, to improve care.

中文翻译：

---

2 型糖尿病的妊娠结局：系统评价和荟萃分析。


目的 2 型糖尿病 （T2D） 现在占英国影响妊娠的既往糖尿病的大部分。我们的目的是确定与 1 型糖尿病 （T1D）、妊娠糖尿病 （GDM） 和非糖尿病妊娠相比，它对妊娠结局的影响。数据来源 检索了 2009-2024 年 1 月 1 日的 PubMed。研究合格标准 队列观察性研究报告了 10 例或更多 T2D 妊娠中至少一项主要结局的原始数据符合纳入标准。还收集了比较糖尿病和非糖尿病妊娠。研究评价和综合方法 主要结局包括先天性异常、死产、新生儿和围产期死亡率、出生体重、胎龄前大号率 （LGA）、胎龄前小号率 （SGA） 和巨大儿。PROSPERO ID CRD42023411057。结果 共分析 47 项研究。每项分析中的妊娠数量根据所分析结局的可用数据而变化，但从 723 到 4,469,053 例怀孕不等。与 T1D 妊娠相比，T2D 更有可能生出 SGA 婴儿，新生儿和围生儿死亡率更高 （OR 2.29,95% CI 1.12 - 4.67;OR 1.53 95% CI 分别为 1.20 至 1.94 和 OR 1.31 95% CI 1.07 至 1.61）。与 GDM 相比，T2D 更有可能生出先天性异常 （OR 1.91， 95% CI 1.04 - 3.50）、LGA （OR 3.49， 95% CI 2.49 - 4.89）、新生儿死亡率 （OR 3.96， 95% CI 3.38 - 4.64） 和死产 （OR 16.55， 95% CI 5.69 - 48.11）。与非糖尿病妊娠相比，T2D 更有可能生出先天性异常 （OR 1.76， 95% CI 1.11 - 2.79）、LGA （OR 2.79， 95% CI 1.93 - 4.04）、围产期死亡率 （OR 4.18， 95% CI 2.91 - 6.01） 和死产 （OR 7.27， 95% CI 3.01 - 17.53）。 结论 T2D 妊娠与其他形式的妊娠期糖尿病相比，围产期死亡率更高。鉴于其发病率的日益增加，医疗保健提供者和政策制定者都需要更多地了解与 T2D 相关的不良妊娠结局，以改善护理。