96-OR: Parameters of Glycemic Variability as Predictors of LGA in Pregnant Women with Well-Controlled Type 1 Diabetes (T1D)

Abstract

Background: According to the current recommendations, pregnant patients with T1D are encouraged to use continuous glucose monitoring (CGM) systems. The use of CGM reduces the risk of LGA births and neonatal hypoglycemia. This study aimed to assess the influence of the parameters of glycemic variability on the risk of LGA births. Methods: The study cohort included 75 patients with T1D who were using CGM systems throughout pregnancy. The study population we divided into two subgroups: mothers of LGA and non-LGA newborns. We defined LGA as a birth weight above the 90th percentile. Calculated birthweight percentiles we adjusted for maternal weight, height, parity, and ethnicity, as well as the infant’s sex and gestational age. For each trimester separately and for the whole pregnancy, we calculated indicators of glucose variability, such as time spent in and above the target range (TIR, TAR). We also calculated the %CV, MODD, MAGE, GRADE, %GRADE hypo, %GRADE hyper, CONGA (1, 2h), LBGI, and HBGI. Results: The mean values of glycated haemoglobin in both groups met the criteria of well-controlled T1D in each trimester of pregnancy. Nevertheless, there were 25/75 infants with LGA. Only the 1st-trimester maternal HbA1c values were significantly higher in the group of LGA infants. However, in the LGA-mothers, mean glucose levels and TAR values were significantly increased in each trimester. Bivariate logistic regression revealed that the LGA risk was positively associated with %GRADE hyper, MODD, MAGE, and TAR, and negatively associated with LBGI, %GRADE hypo, and TIR. After the adjustments for the maternal age, pregestational BMI, gestational weight gain, and HbA1c values, only the relationships with the first trimester’s %GRADE hypo and %GRADE hyper as well as %GRADE hypo calculated for whole pregnancy remained significant. Conclusion: The parameters of glucose variability rather than HbA1c may help predict LGA infants, especially in patients with well-controlled diabetes. Disclosure R. Sibiak: None. B. Mrzewka-rogacz: None. U. Mantaj: None. P. Gutaj: None. E. Wender-ozegowska: Advisory Panel; Self; Novo Nordisk, Board Member; Self; Medtronic, Other Relationship; Self; Medtronic, Novo Nordisk.