{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T19:11:34Z","timestamp":1757704294471},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T00:00:00Z","timestamp":1374624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The reason for the fivefold increased risk of stillbirth in women with diabetes is not known. Further understanding of the underlying mechanisms may facilitate identification of pregnancies at increased risk. We have compared post\u2010mortem reports in matched pairs of stillbirths in women with and without diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Post\u2010mortem reports were provided by the Centre for Maternal and Child Enquiries. Stillbirths as a result of lethal congenital and genetic abnormalities were excluded. Whole body, placenta and organ weights and histo\u2010pathological findings in cases and controls were compared and also related to published reference values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed post\u2010mortem reports on 23 matched pairs of stillbirths from 2009 to 2010. Mean placental weight in women with diabetes was 75\u00a0g less than in control subjects (95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u2212143 to \u22127\u00a0g; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.032). In maternal diabetes, the thymus was often small and showed a \u2018starry sky\u2019 pattern on histology in 11 of 20 cases compared with four of 22 controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). This histological finding was associated with a particularly low mean placental weight z\u2010score \u22122.1 (1.1) standard deviations below a reference population corrected for gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In over half of the stillbirths occurring in women with diabetes, there was a \u2018starry sky\u2019 appearance in the fetal thymus on histology, this being associated with a small placenta. These findings are consistent with a critical subacute metabolic disturbance being a prominent cause of the increased risk of stillbirth in pregnancies complicated by maternal diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12272","type":"journal-article","created":{"date-parts":[[2013,7,24]],"date-time":"2013-07-24T21:20:15Z","timestamp":1374700815000},"page":"1219-1224","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Differences in post\u2010mortem findings after stillbirth in women with and without diabetes"],"prefix":"10.1111","volume":"30","author":[{"given":"A.","family":"Edwards","sequence":"first","affiliation":[{"name":"School of Biomedical Sciences University of Nottingham Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Springett","sequence":"additional","affiliation":[{"name":"Centre of Environmental and Preventive Medicine Barts and the London School of Medicine and Dentistry London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Padfield","sequence":"additional","affiliation":[{"name":"Department of Histopathology Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Dorling","sequence":"additional","affiliation":[{"name":"Department of Neonatology Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Bugg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Mansell","sequence":"additional","affiliation":[{"name":"School of Biomedical Sciences University of Nottingham Nottingham"},{"name":"Department of Diabetes and Endocrinology Nottingham University Hospitals NHS Trust 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