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

OBJECTIVE: Our purpose was to evaluate the association between birth weight (BW) and fetal death (FD) among pregnant nondiabetic and diabetic patients.

STUDY DESIGN: 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.

RESULTS: 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.

CONCLUSION: The FD rate is increased when birth weight is > or =4250 g in nondiabetic patients and > or =4000 g in diabetic patients.