958: Congenital malformation rates in a contemporary cohort with type 1 and type 2 diabetes mellitus

Abstract

To evaluate fetal anomalies in women with type 1 and type 2 diabetes mellitus (DM). All women with pregestational diabetes who delivered at our institution from May 1, 2009 through December 31, 2018 were ascertained. Women who delivered a singleton live- or stillborn infant with a major malformation as defined by EUROCAT criteria were identified, excluding infants with confirmed chromosomal abnormalities. Hgb A1c values were obtained at the first prenatal visit. In infants with multiple system anomalies, each malformation was considered separately. Statistical analysis was conducted using Student’s t and chi-squared test. A total of 1676 pregnancies in 1403 women with pregestational diabetes delivered at our institution. Diabetes type was available 1594 pregnancies. One hundred and forty-nine were complicated by type 1 DM, and 1445 with type 2 DM. There were 129 pregnancies in 128 women who delivered an infant with at least one major malformation, an overall anomaly rate of approximately 8%. Of these, 18 (14%) were type 1 diabetics. In those that delivered an anomalous infant, mean hgb A1c and duration of disease were significantly higher in type 1 diabetics (Table 1). However, anomaly rates between the two groups were not statistically different, 12% versus 7%, p=.06. There was no difference in the number of women who delivered an infant with multiple anomalies, nor was there a difference in the rate of cardiac anomalies (Table 1). Additionally, there was no difference in the rate of lesions requiring specialized cardiac care in the immediate neonatal period (Table 2). In women who delivered an anomalous infant, hemoglobin A1c values were higher in type 1 diabetics than those with type 2 diabetes mellitus. However, anomaly rates between the two groups did not significantly differ, though this finding may be limited by the small number of type 1 diabetics.View Large Image Figure ViewerDownload Hi-res image Download (PPT)