The O:E mortality ratios for NON and DM for the PRE and POST eras were 0.75 versus 0.74 (P = .51) and 0.69 versus 0.52 (P<.001) respectively, and among DM with A1C ≥7% were 0.74 versus 0.52 (P = .004).
Our results suggest that post receptor defects are present in the insulin signaling pathway in placenta of women with pregnancies complicated by diabetes and obesity.
The greater the severity of the diabetes (greater fasting hyperglycemia) the greater the post-receptor defect, and in those patients with more significant fasting hyperglycemia the post-receptor defect is the predominant abnormality leading to the insulin resistant state.