Pregnancy outcomes in women with onset of type 1 diabetes mellitus less than 18 years of age

Abstract

BackgroundPregnancy in women with type 1 diabetes mellitus (T1DM) is associated with an increased risk of congenital malformations, obstetric complications and neonatal morbidity. This study aims to investigate maternal, perinatal and neonatal outcomes of pregnancies in women with onset of T1DM less than 18 years of age.MethodsThis retrospective cohort study extracted data regarding prenatal, intrapartum and postnatal outcomes of pregnancies in women with onset of T1DM<18 years identified from the diabetes in pregnancy register at University Maternity Hospital Limerick, treated from July 1, 2007 to July 1, 2017.ResultsSeventeen women with onset of T1DM <18 years gave birth to 23 live infants during the period studied. 73.9% of pregnancies were unplanned. Only 21.7% of pregnancies took preconceptual folic acid. 60.9% of infants required treatment for hypoglycemia.ConclusionThe high prevalence of unplanned pregnancy and poor uptake of prepregnancy care must be improved on in order to improve outcomes for this high-risk group.

Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms

“…Women with type 1 diabetes mellitus (T1DM) are also characterized by an increased risk of developing preeclampsia and adverse pregnancy outcomes, and these risks are significantly higher than those in T2DM [ 391 , 392 , 393 , 394 , 395 ]. In this regard, it becomes necessary to reduce these risks, for which, traditionally, insulin therapy is used, both in the period before and during pregnancy.…”

ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes in adolescence

“…However, most pregnancies in young women with diabetes are unplanned and associated with suboptimal glycemic control. 131 , 132 , 138 , 139 A fifth of live‐born infants of unplanned pregnancies in adolescents with Type 2 diabetes had major congenital malformations, despite recommendations about early counseling on contraception and pre‐pregnancy counseling. 140 Recent studies show worse outcomes in pregnancies in adolescents with diabetes and higher healthcare utilization during pregnancy, 137 including a higher risk of preeclampsia and larger babies than adult women with pregestational diabetes.…”

“…A planned pregnancy in a person with diabetes in optimal glycemic control and good health carries only slightly higher risks than those in the general population but not as elevated as previously reported in those with suboptimal glycemic control. However, most pregnancies in young women with diabetes are unplanned and associated with suboptimal glycemic control 131,132,138,139 . A fifth of live‐born infants of unplanned pregnancies in adolescents with Type 2 diabetes had major congenital malformations, despite recommendations about early counseling on contraception and pre‐pregnancy counseling 140 .…”

Sexual health and function in women with diabetes

“…21 Third that some structured education programmes, such as X-PERT Diabetes, Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) and Dose Adjustment For Normal Eating (DAFNE), in the United Kingdom do not discuss it, perhaps because this is not recognized as a problem in UK diabetes guidelines. 26 Fourth, that diabetes specialists might be more concerned with preventing un-planned pregnancy in women with diabetes, a significant issue for women with both types of diabetes 27,28 rather than the problems experienced by women with sexual dysfunction or feel awkward initiating a conversation. 28 And finally, that although sexual dysfunction is seen as important to well-being in men with diabetes HCPs may be unaware of the impact of sexual dysfunction for women.…”