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- W2417387910 abstract "Following the introduction of insulin by F. G. Banting and C. H. Best in the early 1920’s, diabetes mellitus gradually became a relatively common complication of pregnancy. During the 1930’s and 1940’s, however, the reported mortality rate in the fetuses and neonates of women with this complication varied from almost nil to 70 per cent or more. To a great extent this variation resulted from differences in the severity of the disease and the degree of associated complications in those cases reported. White, of Boston’s Joslin Clinic, first brought some semblance of order into the reports of results with her clinical classification of diabetes based on the age at onset of the disease, its duration, and the presence of atherosclerotic vascular disease and renal complications. In addition, this classification allowed a partial prediction of the course of an individual diabetic patient during pregnancy and the chances for survival of the newborn infant. In 1952, White reported on the outcome of pregnancy in 278 diabetic women. Although 100 per cent of the infants of Class A patients were live-born, the survival rates of patients with clinically overt disease were as follows: Class B, 67 per cent; Class C, 48 per cent; Class D, 32 per cent; Class E, 13 per cent. (Joslin, E. P., Root, H. F., White, P., and Marble, A., editors: The Treatment of Diabetes Mellitus, ed. 9, Philadelphia, 1952, Lea 8c Febiger, Publishers, p. 676). In 1965, she added to the classification those patients with proliferating retinopathy (Class R) (Pregnancy and diabetes, medical aspects, Med. Clin. North Am. 49: 1015, 1965). Recently, the classification was modified further (Diabetes mellitus in pregnancy, Clin. Perinatol. 1: 33 1, 1974). White also contributed to knowledge of the newborn infant of the diabetic mother and of juvenile diabetes by presenting the classic description of the natural course of insulin dependency and neuropathic and vascular complications (Childhood diabetes, its course, and influence on the second and third generations. The Banting Memorial Lecture, Diabetes 9: 345,196O). Because of her leadership in the early diagnosis and rigorous management of prenatal care of women with this disease, White must be credited, to a great degree, with the decrease in the perinatal mortality rate from about 50 per cent three or four decades ago to 3 or 4 per cent at present." @default.
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- W2417387910 date "1947-04-01" @default.
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- W2417387910 title "Pregnancy complicating diabetes." @default.
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