Maternal and Neonatal Outcomes in Pregnancy Complicated by Type 1 Diabetes Mellitus

Abstract

Aims: To assess the risk of adverse pregnancy outcomes in pre-gestational type 1 diabetes mellitus (T1DM) as compared to gestational diabetes mellitus (GDM) or pregnancy without diabetes and examine the effect of glycemic control in late pregnancy on these outcomes in T1DM. Methods: This retrospective study comprised of 61 cases of pre-gestational T1DM, 244 cases of GDM, and 244 control pregnancies. Data regarding demographics, obstetric and perinatal outcomes were extracted from the hospital discharge database. Result: Compared to the pregnancies without diabetes, women with T1DM had higher risks of polyhydramnios [odds ratio(OR) 4.5] and cesarean section (OR 21.2), while the odd ratios for these outcomes in GDM were 2.4 and 1.9, respectively. Preeclampsia, preterm delivery, preterm premature rupture of membranes and postpartum hemorrhage occurred more in women with T1DM than GDM. Severe perinatal outcomes including stillbirth and congenital malformations were reported in T1DM only. Moreover, women with T1DM were more likely to present abnormal fetal growth, either low birthweight (OR 4.0) or large for gestational age (OR 5.0). Severe perinatal outcomes including stillbirth and congenital malformations were reported in T1DM only. Poorly controlled HbA1c in late pregnancy was significantly associated with an increased risk of preterm birth (OR 2.01) in T1DM. Conclusions: Women with T1DM have considerably increased risks of adverse pregnancy outcomes, which appear more critical than the contemporary outcomes in women with GDM. Thus, a specific routine is required for pregnancy in T1DM to improve the glycemic control and obstetric care. Disclosure Y. Bi: None. Q. Xu: None. J. Lu: None. J. Hu: None. J. Li: None. Z. Ge: None. D. Zhu: None.