57 Preeclampsia influence on the newborn’s weight percentile of pregnant women with type 1 diabetes mellitus

Abstract

Background Preeclampsia (PE) has a higher incidence in women with type 1 diabetes mellitus (DM). While the loss of glycemic control cause hyperinsulinemia and exaggerated fetal growth, diabetic vasculopathy can be associated with placental insufficiency and fetal growth restriction, similarly to preeclampsia. Objective To evaluate the influence of pre-eclampsia in newborn’s weight percentile of pregnant women with type 1 diabetes mellitus. Methods A prospective cohort study that evaluated pregnant women diagnosed with type 1 diabetes mellitus whose prenatal follow-up was performed at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP) between the years 2013 and 2016. For analysis of the results at the end of the study, the patients were divided into two groups: without PE (I) and with PE (II). Statistical tests chi-square and analysis of variance (ANOVA) were performed with the help of IBM SPSS 16 software, considering the significance level of p Results Of the 65 patients followed in the period, 20 (30.8%) developed preeclampsia. The mean weight percentile at birth was 73.23 (±26.46) in group I and 52.98 (±27.49) in group II, p = 0.0044. The frequency of newborns large for gestational age was 37.7% ( n = 17) in group I and 5% ( n = 1) in group II (RR = 0.1294, CI = 0.01–0.90, p = 0.0395). There was no statistical difference in the frequency of infants small for gestational age. The average weight at birth was 3283.13 g (±644.89) in group I and 2785.25 g (±660.03) in group II, p = 0.006. There was no difference of factors such as age, disease duration, body mass index and presence of target organ lesions between the groups. Conclusions Preeclampsia decreases the mean of newborn’s weight percentile of pregnant women with type 1 diabetes mellitus, reducing the incidence of those classified as large for gestational age. In this cohort, there was no significant influence on the frequency of infants small for gestational age.