Risk factors for pregnancy outcomes in Type 1 and Type 2 diabetes

Abstract

Background Understanding the risk factors and pregnancy outcomes in women affected by Type 1 and Type 2 diabetes is important for pre‐pregnancy counselling. Aim To explore differences in pregnancy outcomes between women with Type 1 and Type 2 diabetes, and healthy controls, and to examine the relationships between potential adverse risk factors and pregnancy outcomes in this cohort of women. Methods This is a 10‐year retrospective study of women with Type 1 diabetes (n = 92), Type 2 diabetes (n = 106) and healthy women without diabetes (controls) (n = 119) from a tertiary obstetric centre. Clinical and biochemical characteristics of women with Type 1 and Type 2 diabetes were determined and related to major obstetric outcomes using univariate analysis. Results Women with pre‐existing diabetes had higher adverse pregnancy outcomes (preeclampsia, emergency caesarean section, preterm birth <32 and 37 weeks, large for gestational age, neonatal jaundice, Apgar score < 7 at 5 min, neonatal intensive care admission and neonatal hypoglycaemia) compared to controls. A higher birth weight gestational centile (97.4% vs 72.4%, P = 0.001) and large for gestational age rate (63.4% vs 35.8%, P = 0.001) were observed in Type 1 diabetes compared to Type 2 diabetes. There were no differences in other outcomes between women with Type 1 and 2 diabetes. Conclusion In this exploratory study, risk factors for maternal adverse outcomes differ between Type 1 and Type 2 diabetes. Maternal and foetal adverse outcomes were higher in pregnancies affected by diabetes compared to healthy women but occurred with similar frequency in women with Type 1 and Type 2 diabetes.

Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus

“…With regard to women with T1DM, in the present study about 50% of them had perinatal/neonatal complications such as macrosomia and consequently higher birth weight percentiles, and this percentage was higher than in women with T2DM, in line with other studies [ 19 ]. We found maternal weight gain during pregnancy was a risk factor, rather than pregestational HbA1c.…”

Maternal-fetal Complications in Pregnancy: A Retrospective Comparison Between Type 1 and Type 2 Diabetes Mellitus

“…With regard to women with T1DM, in the present study about 50% of them had perinatal/neonatal complications such as LGA and consequently higher birth weight percentiles and this percentage was higher than in women with T2DM, in line with other studies [19]. We found LGA was correlated with maternal weight gain during pregnancy, rather than pregestational HbA1c.…”

Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

“…However, the number of PE and GDM-2 cases was small (24 (2.6%) and 21 (2.3%), respectively). Our methodology was probably influenced by the low incidence of PE in our study; we excluded some risk factors of preeclampsia, such as multiple pregnancy and pre-existing chronic diseases [ 7 , 24 ]. Other PE/GH risk factors such as infertility treatment, hypertension in previous pregnancy, and smoking were more common in the women who developed GH or PE than in normotensive women; however, the number of women with these risk factors was low.…”

“…Other PE/GH risk factors such as infertility treatment, hypertension in previous pregnancy, and smoking were more common in the women who developed GH or PE than in normotensive women; however, the number of women with these risk factors was low. Many studies have shown that assisted reproductive techniques, including in vitro fertilization, are associated with a higher risk of hypertension in pregnancy, including various preeclampsia phenotypes [ 7 , 24 , 25 , 26 ]. The effect of smoking on the risk of preeclampsia is ambiguous, but, in our previous study, smoking in the first trimester increased the risk of GH and PE [ 27 ].…”